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Sex determines cardiovascular hemodynamics in hypertension

Journal of Human Hypertension volume 29, pages 610–617 (2015)Cite this article

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Abstract

The aim of this study was to evaluate the influence of sex on cardiovascular hemodynamics and heart remodeling in 144 patients with arterial hypertension that underwent: (1) echocardiography (that is, indices of left ventricular diastolic function: e′, E/e′), (2) impedance cardiography (that is, systemic vascular resistance (SVR), total artery compliance (TAC) and Heather index (HI)) and (3) applanation tonometry (augmentation index (AI), central systolic and diastolic blood pressure (CSBP, CDBP), central pulse pressure (CPP)). Women, in comparison with men, revealed to have: (1) stiffer arteries—lower TAC (1.93±0.55 vs 2.16±0.59 ml per mm Hg; P=0.025), higher CSBP (128.7±14.9 vs 123.4±13.2 mm Hg; P=0.036), CPP (39.9±9.5 vs 33.8±9.0 mm Hg; P=0.0002), AI (31.5±8.7 vs 17.5±12.7%; P<0.00001), SVR (1257.6±305.6 vs 1091.2±240.7 dyn × s × cm−5; P=0.002) and (2) higher left ventricular performance—HI (16.3±4.3 vs 11.7±3.2 Ohm × s2; P<0.00001). In women CSBP, CPP and AI were more clearly associated with left ventricular filling pressure (e′) (r=−0.39, r=−0.45, r=−0.44, P<0.01; respectively). These relations were remarkably weaker in men. Hypertensive women characterized with lower large artery compliance, more pronounced augmentation of central blood pressure and more distinctive association of central blood pressure with left ventricular diastolic function. Sex differences in cardiovascular function can impact the individualized management of arterial hypertension.

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Acknowledgements

The study was supported by the Ministry of Science and Higher Education/Military Institute of Medicine, Warsaw, Poland (grant no 148/WIM).

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  1. Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland

    P Krzesiński, A Stańczyk, G Gielerak, B Uziębło-Życzkowska, M Kurpaska, K Piotrowicz & A Skrobowski

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Correspondence to P Krzesiński.

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Krzesiński, P., Stańczyk, A., Gielerak, G. et al. Sex determines cardiovascular hemodynamics in hypertension. J Hum Hypertens 29, 610–617 (2015). https://doi.org/10.1038/jhh.2014.134

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