Gender Difference of the Relationship between Arterial Stiffness and Blood Pressure Variability in Participants in Prehypertension

Abstract

Aim. The association of pressure load with elasticity in vascular system has not been studied fully. We proposed a hypothesis whether gender could modify the association of blood pressure variability (BPV) and arterial stiffness assessed by carotid-femoral pulse wave velocity (CF-PWV) in prehypertensive patients. Methods. 24h ambulatory blood pressure monitoring (24h-ABPM) and CF-PWV were measured in 723 participants with prehypertension. Univariate and multivariate regression analyses of these clinical and biological parameters were performed in total population, male and female. Results. A total of 723 participants (mean age 59.76 ± 12.37years, male 329 and female 394) were enrolled into the study. Compared with female, body mass index (BMI), fasting plasma glucose (FPG), uric acid (UA), and homocysteine (HCY) were significantly higher (all p < 0.05). Arterial stiffness (CF-PWV, male versus female, 10.89 ± 2.50 versus 10.33 ± 2.13 m/s, p=0.004) and BPVs (male versus female, 24 h SBPV 13.2 ± 5.11 versus 13.03 ± 5.20; 24 h DBPV 10.34 ± 3.87 versus 9.64 ± 3.59; N SBPV 11.90 ± 6.60 versus 10.94 ± 4.79; N DBPV 9.64 ± 5.87 versus 8.20 ± 4.48, all p<0.05) were higher in male. Multivariable linear regression analysis showed that 24 h BPV were linearly and positively related to CF-PWV in total population (24h SBPV, B=0.033; 24 h DBPV, B=0.035, both P<0.05) and female (24h SBPV, B=0.041; 24h DBPV, B=0.067, both P<0.05) independent of traditional risk factors and medications. Conclusion. BPV was independently associated with arterial stiffness in total population and the relation was modified by gender. 24 h BPVs in prehypertensive patients were useful to identify the early arterial stiffness. Clinical Trials Registration. This trial was registered with Clinical Trials.gov Identifier: NCT02569268.

Adjustment for body mass index changes inverse associations of HDL-cholesterol with blood pressure and hypertension to positive associations

“…10 A possible explanation for this could be due to arterial stiffness being greater in males than in females. 33,34 The current study shows that after exclusion of hypertensive participants, higher HDL-C became associated with lower BP in males, suggesting that hypertension, which could worsen arterial stiffness, 35 may contribute to the sex difference in the association between HDL-C and BP.…”

Relationship between the Central and Regional Pulse Wave Velocity in the Assessment of Arterial Stiffness Depending on Gender in the Geriatric Population

“…To the best of our knowledge, this is the first study that demonstrates differences in cf-PWV between genders in nearly all homogeneous patients in terms of classic comorbidities such as hypertension, diabetes mellitus, metabolic syndrome, chronic obstructive pulmonary diseases, and heart failure among Polish geriatric patients and shows differences in the impact of individual risk factors on the cfPWV value in gender groups. There are some studies that have assessed the relationship between arterial stiffness and gender, but most of them have been conducted in the younger population [23][24][25][26][27]. No significant difference was found for PWV, arterial age, and augmentation index in an analysis of gender and arterial stiffness among smokers (mean age 38).…”

“…In participants with prehypertension (mean age 59.76 + 12.37) selected from the BEST study, males had higher PWV than females (10.89 vs. 10.33 m/s, respectively). However, differences in the distribution of other CV risk factors were observed, such as: (1) age, BMI, FPG, UA, and homocysteine being higher in males compared with females, and (2) TC, HDL-C, and LDL-C being higher in females [24]. In a study conducted among the Tallinn population aged 20-65, a higher PWV was observed in hypertensive men aged equal to or above 50 years, as well as in hypertensive women with diabetes and in apparently healthy women with increased apolipoprotein B [25].…”

Clinical Evaluation Tool for Vascular Health–Endothelial Function and Cardiovascular Disease Management

“…Twenty-four-hour ambulatory blood pressure monitoring can automatically and continuously record blood pressure changes within 24 h, including daytime and nighttime systolic blood pressure, diastolic blood pressure, mean blood pressure, maximum and minimum blood pressure, etc. Blood pressure variability directly reflects the stiffness and buffering function of blood vessels and is closely related to the occurrence of CVD, such as cognitive impairment [ 55 , 56 ]. Dynamic electrocardiogram (ECG) was first developed by Holter in 1957.…”