Gender differences in the elastic properties of the arterial wall in patients with arterial hypertension during the age-related evolution

Abstract

Age-related changes in the elastic properties of the arterial wall in patients with arterial hypertension increase the risk of CV events. Additional CV risk factors in women lead to gender differences in vascular stiffness. The aim: to determine changes in the elastic properties of the arterial wall in patients with hypertension depending on gender, with considering of the age-related changes. Materials and methods: 258 patients with arterial hypertension stage II were examined: 132 women (55.56±7.69 years) and 126 men (51.75±8.42 years). By age, patients were divided into 5 subgroups (37–45, 45–49, 49–54, 54–58 and 58–69 years). The following were assessed: pulse wave velocity in the aorta (PWVao), central systolic blood pressure in the aorta (SBPao), central pulse blood pressure (cPBP), augmentation index in the aorta (Aix ao) and on the brachial artery (Aix br), PWV index (PWVind), amplification blood pressure (BPamp), pulse blood pressure index (C/B indPBP). Results: In the absence of differences in peripheral hemodynamics in all groups, women aged 49-54 years had a magnification of the PWV by 2 m/s, and, in comparison with men, this difference was 1.65 m/s (p <0.05). Aix br and Aix ao were also superior to men in all groups, and in 49-54 years old, this difference was greatest and amounted to 39 % and 20 %, respectively. At this age, SBPao was also significantly raised in women, with a difference of 15 mmHg relative to men (p=0.038). In all age groups, women had negative values of the BPamp in contrast to men. In women, PWV correlated with the duration of hypertension (r=0.21; p<0.05), SBP (r=0.40), DBP (r=0.35), cPBP (r=0.43), in contrast to men, where PWVao was associated only with the heart rate (r=0.30). Conclusion: In women with hypertension, changes in vascular wall stiffness occur earlier than in men with significant growth at 49–54 years. In women, the elastic properties of arteries are associated with the level of blood pressure and duration of the disease, and in men - with the level of the heart rate