Women exhibit a greater age-related increase in proximal aortic stiffness than men

Waddell, Tamara K.; Dart, Anthony M.; Gatzka, Christoph D.; Cameron, James D.; Kingwell, Bronwyn A.

doi:10.1097/00004872-200112000-00014

Cited by 187 publications

(160 citation statements)

References 40 publications

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“…elastin and more collagen fibers in the arterial wall, proliferation of smooth muscle cells or to increased atherosclerosis [30]. The preponderance of female patients amongst those with isolated uncontrolled SBP is consistent with other studies, showing that age-related stiffness of large arteries is more pronounced in women than in men [31].…”

Section: Discussionsupporting

confidence: 87%

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Bøg-Hansen

Lindblad

Gullberg

et al. 2003

Diabetes Obesity Metabolism

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Metabolic disorders associated with uncontrolled hypertension.Bøg-Hansen, Erik; Lindblad, Ulf; Gullberg, Bo; Melander, Arne; Råstam, Lennart Link to publication Citation for published version (APA): Bøg-Hansen, E., Lindblad, U., Gullberg, B., Melander, A., & Råstam, L. (2003). Metabolic disorders associated with uncontrolled hypertension. Diabetes, Obesity and Metabolism, 5(6), 379-387. DOI: 10.1046/j.1463-1326 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Aim: To examine the prevalence and characteristics of uncontrolled hypertension (HT). Methods: A cross-sectional community-based study (1992-93) was carried out in Skara, Sweden, including 894 patients who consecutively underwent an annual follow-up at the hypertension outpatient clinic in primary care. Controlled HT was defined as diastolic blood pressure (DBP) 90 mmHg and systolic blood pressure (SBP) 160 mmHg and was used as reference. Uncontrolled DBP was defined as DBP >90 mmHg regardless of SBP level, and isolated uncontrolled SBP was defined as SBP >160 mmHg and DBP 90 mmHg. Proportions were age-standardized using the Skara population as reference. Results: The prevalence of uncontrolled HT was 43% (isolated uncontrolled SBP 18% and uncontrolled DBP 25%). Both men and women with isolated uncontrolled SBP were older (73 years, CI: 70-75; and 73 years; CI: 72-75) than patients with controlled HT (64 years, CI: 63-66; and 65 years, CI: 64-66). Men and women with known cardiovascular disease (CVD) less often had isolated uncontrolled SBP (OR: 0.4, CI: 0.2-0.9; and OR: 0.5, CI: 0.3-0.9), whereas men and women with known diabetes more often had uncontrolled DBP (OR: 2.3, CI: 1.3-4

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Section: Discussionsupporting

confidence: 87%

Manuscript Submission Now on the Web

Bøg-Hansen

Lindblad

Gullberg

et al. 2003

Diabetes Obesity Metabolism

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“…Most studies have not found any difference in age-related aortic stiffening between men and women (Heijden-Spek et al 2000; Smulyan et al 2001); however, other studies have suggested a pronounced age-related increase in aortic stiffness in women more than men, mainly during menopause (Waddell et al 2001;Vermeersch et al 2008). These discordant findings have been ascribed to an intrinsic difference in arterial properties between men and women, possibly influenced by sex steroids (Waddell et al 2001;Rossi et al 2011), which may be emphasized in the presence of high BP (Boutouyrie and Vermeersch 2010) or other CV risks such as obesity and diabetes (Rossi et al 2011). Our results were adjusted for the classic CV risk factors by a forward stepwise multiple regression analysis; however, gender remained correlated with PWV only in normotensive subjects with other risk factors.…”

Section: Discussionmentioning

confidence: 95%

Age- and gender-specific reference values of pulse wave velocity for African adults: preliminary results

Magalhães

Capingana

Silva

et al. 2013

AGE

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Pulse wave velocity (PWV) is an independent predictor of cardiovascular (CV) risk. Higher PWV values have been observed in Africans; however, there are no established age-and gender-adjusted reference values for this population. Therefore, PWV was measured using a validated device (Complior SP) in 544 subjects recruited from an occupational cohort of employees of a public university in Angola. Since high blood pressure (BP) is an important factor influencing PWV, a subsample of 301 normotensive subjects (aged 22-72 years) was selected for this study. A subset of 131 individuals without CV risk factors was considered the healthy group (HG), while the entire group (n = 301) comprised the less healthy group (LHG). Predictors of PWV were evaluated using multiple regression analyses and age-and gender-specific percentile tables and curves were constructed. Age and PWV means were 36±9.7 years and 6.6±1.0 m/s in the HG, respectively, and 39.9±10.2 years and 7.3± 1.3 m/s in the LHG. Age and plasma uric acid (UA) were the only significant PWV predictors in the HG, while age, mean BP (MBP), and gender showed significant prediction of PWV in the multiple regression analysis in the LHG. Age-and gender-adjusted reference values of PWV were provided for healthy and less healthy normotensive Africans. Considering the small sample size of our cohort, these preliminary results should be used cautiously until data on robust sample of the general population can be obtained.

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“…6 Females have been shown to demonstrate a greater age-related increase in proximal aortic stiffness and pulse pressure compared to males. 15,17 Arterial elastance at each stage of exercise was significantly higher in females, and the differ- ence was driven by the fact that end systolic pressure at each stage of exercise was similar despite the significantly lower SV. This may be attributable to the lower arterial compliance in females compared to males.…”

Section: Gender Difference Of Eaimentioning

confidence: 99%

Gender-Related Difference in Arterial Elastance During Exercise in Patients With Hypertension

Park

Shim

et al. 2008

Hypertension

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Abstract-Exercise intolerance and heart failure with preserved ejection fraction are common in females. Recently, arterial stiffness has been suggested to be a significant contributor in the development of heart failure. How gender difference affects arterial stiffening and its response to exercise is not well known. We hypothesized that arterial elastance index during exercise would be more abnormal in females with hypertension than males. Arterial elastance index was estimated as arterial end systolic pressure/stroke volume controlled for body surface area and was measured at rest and during graded supine bicycle exercise (25 watts, 3-minute increments) in 298 patients with hypertension (149 males; 149 females; mean age, 59). The subjects were divided into 2 groups by gender. Exercise duration was significantly shorter in females compared to males (692Ϯ222 versus 483Ϯ128 seconds, PϽ0.001). Although arterial elastance index at baseline was significantly higher in males, the magnitude of increase was steeper in females with the magnitude of change at 75 W of exercise being significantly higher in females compared to males (0.69Ϯ0.83 versus 0.43Ϯ0.69, Pϭ0.018). Arterial elastance index at each stage of exercise up to 75 W was independently associated with decreased exercise duration. In conclusion, despite lower arterial elastance index at rest, the increase during exercise was steeper in women with hypertension, suggesting a gender-related difference in dynamic arterial stiffness. The arterial elastance index during exercise was significantly associated with exercise duration in patients with hypertension. Key Words: gender Ⅲ arterial elastance index Ⅲ exercise Ⅲ hypertension Ⅲ heart failure I n epidemiology studies, nearly 50% of patients with heart failure have preserved ejection fraction and hypertension is considered to be the most important cause of heart failure with preserved ejection fraction. Interestingly, advanced age and the female gender are known to be associated with development of heart failure with preserved ejection fraction because the prevalence of heart failure with ejection fraction increases sharply with age than systolic heart failure, especially in females. 1,2 Recently, arterial stiffness has been suggested to be a significant contributor in the development of heart failure. 3,4 Increased aortic stiffness in subjects contributed to increased afterload to the heart while reducing coronary perfusion pressure during diastole. 3,4 Greater aortic stiffness may increase myocardial stiffness and left ventricular (LV) diastolic filling pressure, which may be exaggerated during exercise. 5 How gender difference affects arterial stiffening and its response to exercise is not well known; therefore, we hypothesized that arterial elastance index (EaI) during exercise would be more abnormal in female patients with hypertension compared to males. Methods Study PopulationSymptom-limited supine bicycle exercise (25 Watts, 3-minute increments) with simultaneous 2-dimensional and Doppler echocardiography ...

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Women exhibit a greater age-related increase in proximal aortic stiffness than men

Abstract: In men and women matched for mean pressures, the age-related stiffening of large arteries is more pronounced in women, which is consistent with changes in female hormonal status.

Cited by 187 publications

References 40 publications

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Manuscript Submission Now on the Web

Age- and gender-specific reference values of pulse wave velocity for African adults: preliminary results

Gender-Related Difference in Arterial Elastance During Exercise in Patients With Hypertension

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