Sex difference in the mechanical properties of the abdominal aorta in human beings

Abstract

Purpose: A previous study has shown age- and sex-related differences in abdominal aortic compliance. In that study blood pressure determined by auscultation in the brachial artery was assumed to be equal to blood pressure in the abdominal aorta. To validate our findings we investigated the pressure-diameter (P-D) relationship of the abdominal aorta.Methods: Diameter and pulsatile diameter change of the abdominal aorta were determined noninvasively by an ultrasound phase-locked echo-tracking system with simultaneous measurement of aortic pressure resulting in P-D curves in 27 healthy male and female volunteers 23 to 72 years of age. The degree of error in aortic compliance as calculated from blood pressure determined by auscultation of the brachial artery rather than from direct measurement of aortic pressure was evaluated. Compliance was defined as the inverse of pressure strain elastic modulus (Ep) or of stiffness (β).Results: There was no significant difference in the systolic pressure at the two sites, but the diastolic pressure was systematically overestimated by approximately 10 mm Hg when determined by the auscultatory method (p < 0.01) leading to a 15% to 20% underestimation of Ep and stiffness (β). The individual P-D curves exhibited hysteresis, were nonlinear, and revealed that the aorta is more distensible at lower than at higher pressures. The steepness of the P-D curve decreased with increasing age and this occurred at an earlier age in men than in women.Conclusion: This investigation demonstrates a decrease in abdominal aortic wall distensibility with age, which occurs at an earlier age in men, and confirms earlier results by use of the indexes Ep and stiffness (β). This implies that the abdominal aorta in men is more prone to degenerative changes, which may be one of the factors responsible for the sex difference in aortic vascular disease.