Elevated BMI, systolic blood pressure, and fasting glucose throughout childhood and adolescence (ages 8-20) predicted higher forward compression wave intensity in carotid arteries at age 28 in males, but not females. The study tracked 402 participants, finding that males with persistently higher metabolic markers showed greater arterial stiffness patterns associated with future cognitive decline and cerebrovascular disease risk. This research connects childhood metabolic health to early vascular changes that may influence brain aging decades later. The sex-specific finding suggests hormonal or biological differences in how early-life risk factors translate to vascular health. While the 28-year endpoint captures relatively young adults, carotid pulse wave characteristics are established predictors of later cognitive decline, making this an important window for intervention. However, this preprint awaits peer review and the observational design cannot establish causation. The findings reinforce growing evidence that cardiovascular health foundations are laid in childhood, particularly for males, and that maintaining healthy weight, blood pressure, and glucose levels from an early age may protect brain health throughout life.