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

Authors

DOI:

https://doi.org/10.15587/2519-4798.2024.306857

Keywords:

arterial hypertension, arterial wall stiffness, gender features, females, age

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

Author Biography

Kostiantyn Yehorov, Dnipro State medical University

PhD, Associate Professor

Department of Internal Medicine 3

References

  1. Costantino, S., Paneni, F., Cosentino, F. (2015). Ageing, metabolism and cardiovascular disease. The Journal of Physiology, 594 (8), 2061–2073. https://doi.org/10.1113/jp270538
  2. Stratton, J. R., Levy, W. C., Caldwell, J. H., Jacobson, A., May, J., Matsuoka, D., Madden, K. (2003). Effects of aging on cardiovascular responses to parasympathetic withdrawal. Journal of the American College of Cardiology, 41 (11), 2077–2083. https://doi.org/10.1016/s0735-1097(03)00418-2
  3. Avolio, A. P., Deng, F. Q., Li, W. Q., Luo, Y. F., Huang, Z. D., Xing, L. F., O’Rourke, M. F. (1985). Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. Circulation, 71 (2), 202–210. https://doi.org/10.1161/01.cir.71.2.202
  4. Lanzer, P., Boehm, M., Sorribas, V., Thiriet, M., Janzen, J., Zeller, T. et al. (2014). Medial vascular calcification revisited: review and perspectives. European Heart Journal, 35 (23), 1515–1525. https://doi.org/10.1093/eurheartj/ehu163
  5. Oh, Y. S., Berkowitz, D. E., Cohen, R. A., Figueroa, C. A., Harrison, D. G., Humphrey, J. D. et al. (2017). A Special Report on the NHLBI Initiative to Study Cellular and Molecular Mechanisms of Arterial Stiffness and Its Association With Hypertension. Circulation Research, 121 (11), 1216–1218. https://doi.org/10.1161/circresaha.117.311703
  6. Townsend, R. R., Wilkinson, I. B., Schiffrin, E. L., Avolio, A. P., Chirinos, J. A., Cockcroft, J. R. et al. (2015). Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness. Hypertension, 66 (3), 698–722. https://doi.org/10.1161/hyp.0000000000000033
  7. Lundwall, K., Jekell, A., Desta, L., Jacobson, S. H., Kahan, T., Spaak, J. (2022). Aortic stiffness and aortic-brachial stiffness mismatch as markers of renal dysfunction in hypertension. Blood Pressure, 31 (1), 91–99. https://doi.org/10.1080/08037051.2022.2064266
  8. Kaess, B. M., Rong, J., Larson, M. G., Hamburg, N. M., Vita, J. A., Levy, D. et al. (2012). Aortic Stiffness, Blood Pressure Progression, and Incident Hypertension. JAMA, 308 (9), 875–881. https://doi.org/10.1001/2012.jama.10503
  9. Nilsson, P. M., Lurbe, E., Laurent, S. (2008). The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome. Journal of Hypertension, 26 (6), 1049–1057. https://doi.org/10.1097/hjh.0b013e3282f82c3e
  10. Oh, Y. S. (2018). Arterial stiffness and hypertension. Clinical Hypertension, 24 (1). https://doi.org/10.1186/s40885-018-0102-8
  11. O’Rourke, M. F. (2007). Arterial aging: pathophysiological principles. Vascular Medicine, 12 (4), 329–341. https://doi.org/10.1177/1358863x07083392
  12. Cardoso, C. R. L., Salles, G. F. (2022). Prognostic Value of Changes in Aortic Stiffness for Cardiovascular Outcomes and Mortality in Resistant Hypertension: a Cohort Study. Hypertension, 79 (2), 447–456. https://doi.org/10.1161/hypertensionaha.121.18498
  13. Crook, D., Meire, H., Gangar, K. F., Vyas, S., Whitehead, M., Campbell, S. (1991). Pulsatility index in internal carotid artery in relation to transdermal oestradiol and time since menopause. The Lancet, 338 (8771), 839–842. https://doi.org/10.1016/0140-6736(91)91500-t
  14. Gilbert, W.; Moore, T. R., Reiter, R. C., Rebar, R. W., Baker, V. V. (Eds.) (1993). Anatomy and physiology of the placenta, fetal membranes and amniotic fluid. Gynecology and Obstetrics. New York: Churchill Livingston, 209–222.
  15. Gass, M. L. S.; Moore, T. R., Reiter, R. C., Rebar, R. W., Baker, V. V. (Eds.) (1993). Physiology and pathophysiology at the postmenopausal years. Gynecology and Obstetrics. New York: Churchill Livingstone, 883–898.
  16. Arterialna hipertenziia. Klinichna nastanova (2017). Derzhavnyi ekspertnyi tsentr Ministerstva okhorony zdorovia Ukrainy. Available at: https://www.dec.gov.ua/wp-content/uploads/2019/11/kn_artergipert.pdf
  17. Unifikovanyi klinichnyi protokol medychnoi dopomohy Arterialna hipertenziia Pervynna medychna dopomoha (dohospitalnyi etap) Vtorynna (spetsializovana) medychna dopomoha (2012). Arterialna hipertenziia te sertsevo-sudynni zakhvoriuvannia, 1 (21). http://www.mif-ua.com/archive/article/26382
  18. Mancia, G., Kreutz, R., Brunström, M., Burnier, M., Grassi, G., Januszewicz, A, et al. (2023). 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA): Erratum. (2023). Journal of Hypertension, 41, 1874–2071. https://doi.org/10.1097/hjh.0000000000003621
  19. Smulyan, H., Asmar, R. G., Rudnicki, A., London, G. M., Safar, M. E. (2001). Comparative effects of aging in men and women on the properties of the arterial tree. Journal of the American College of Cardiology, 37 (5), 1374–1380. https://doi.org/10.1016/s0735-1097(01)01166-4
  20. Arteriograph. Arteriograph Company. Available at: https://tensiomed.com/devices/arteriograph/ Last accessed: 12.04.2024
  21. Zuo, Y., Chen, S., Tian, X., Wu, S., Wang, A. (2024). Changes in baPWV and the risk of clinical outcomes: a cohort study of Chinese community-based population. Journal of Human Hypertension, 38 (5), 460–466. https://doi.org/10.1038/s41371-024-00902-9
  22. Vasan, R. S., Pan, S., Xanthakis, V., Beiser, A., Larson, M. G., Seshadri, S., Mitchell, G. F. (2022). Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study. Hypertension, 79 (5), 1045–1056. https://doi.org/10.1161/hypertensionaha.121.18776
  23. Takahashi, K., Miura, S., Mori-Abe, A., Kawagoe, J., Takata, K., Ohmichi, M., Kurachi, H. (2005). Impact of Menopause on the Augmentation of Arterial Stiffness with Aging. Gynecologic and Obstetric Investigation, 60 (3), 162–166. https://doi.org/10.1159/000086570
  24. Zaydun, G., Tomiyama, H., Hashimoto, H., Arai, T., Koji, Y., Yambe, M. et al. (2006). Menopause is an independent factor augmenting the age-related increase in arterial stiffness in the early postmenopausal phase. Atherosclerosis, 184 (1), 137–142. https://doi.org/10.1016/j.atherosclerosis.2005.03.043
  25. Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M. et al. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 39 (33), 3021–3104. https://doi.org/10.1093/eurheartj/ehy339
  26. Kim, H.-L., Lee, K.-S., Joh, H. S., Lim, W.-H., Seo, J.-B., Kim, S.-H. et al. (2023). Prognostic Value of Brachial-Ankle Pulse Wave Velocity According to Subjects’ Clinical Characteristics: Data From Analysis of 10,597 Subjects. Journal of Korean Medical Science, 38 (50). https://doi.org/10.3346/jkms.2023.38.e414
  27. Cheng, W., Xu, W., Luan, S., Wen, G., Kong, F. (2023). Predictive value of estimated pulse wave velocity with all-cause and cause-specific mortality in the hypertensive population: the National Health and Nutrition Examination Surveys 1999–2014. Journal of Hypertension, 41 (8), 1313–1322. https://doi.org/10.1097/hjh.0000000000003469
  28. Vasan, R. S., Song, R. J., Xanthakis, V., Beiser, A., DeCarli, C., Mitchell, G. F., Seshadri, S. (2022). Hypertension-Mediated Organ Damage: Prevalence, Correlates, and Prognosis in the Community. Hypertension, 79 (3), 505–515. https://doi.org/10.1161/hypertensionaha.121.18502
  29. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values.’ (2010). European Heart Journal, 31 (19), 2338–2350. https://doi.org/10.1093/eurheartj/ehq165
  30. Blacher, J., Safar, M. E., Guerin, A. P., Pannier, B., Marchais, S. J., London, G. M. (2003). Aortic pulse wave velocity index and mortality in end-stage renal disease. Kidney International, 63 (5), 1852–1860. https://doi.org/10.1046/j.1523-1755.2003.00932.x
  31. Tang, Z., Lu, Y., Hao, Y., Morris, R., Kang, D., Wang, F., Fan, L., Wang, W., Wang, Y., Cheng, F. (2021). The Temporal Pattern of Arterial Stiffness during Aging: A Large-Scale Cross-Sectional Study. Journal of Diabetes Research, 2021, 1–12. https://doi.org/10.1155/2021/3243135
  32. Williams, B., Lacy, P. S., Thom, S. M., Cruickshank, K., Stanton, A., Collier, D. et al. (2006). Differential Impact of Blood Pressure–Lowering Drugs on Central Aortic Pressure and Clinical Outcomes. Circulation, 113 (9), 1213–1225. https://doi.org/10.1161/circulationaha.105.595496
  33. Laurent, S., Cockcroft, J., Van Bortel, L., Boutouyrie, P., Giannattasio, C., Hayoz, D. et al. (2006). Expert consensus document on arterial stiffness: methodological issues and clinical applications. European Heart Journal, 27 (21), 2588–2605. https://doi.org/10.1093/eurheartj/ehl254
  34. Vlachopoulos, C., Aznaouridis, K., O’Rourke, M. F., Safar, M. E., Baou, K., Stefanadis, C. (2010). Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. European Heart Journal, 31 (15), 1865–1871. https://doi.org/10.1093/eurheartj/ehq024
  35. Costa-Hong, V. A., Muela, H. C. S., Macedo, T. A., Sales, A. R. K., Bortolotto, L. A. (2018). Gender differences of aortic wave reflection and influence of menopause on central blood pressure in patients with arterial hypertension. BMC Cardiovascular Disorders, 18 (1). https://doi.org/10.1186/s12872-018-0855-8
  36. Mitchell, G. F., Rong, J., Larson, M. G., Cooper, L. L., Xanthakis, V., Benjamin, E. J. et al. (2023). Longitudinal Hemodynamic Correlates of and Sex Differences in the Evolution of Blood Pressure Across the Adult Lifespan: The Framingham Heart Study. Journal of the American Heart Association, 12 (12). https://doi.org/10.1161/jaha.122.027329
  37. Chen, J., Jin, L., Wu, L., Zhang, M., Wu, X., Hong, Y. et al. (2023). Gender and age disparities in small-to-medium arterial stiffness among the Chinese population. Nutrition, Metabolism and Cardiovascular Diseases, 33 (12), 2355–2362. https://doi.org/10.1016/j.numecd.2023.08.006
  38. Gong, J., Han, Y., Gao, G., Chen, A., Fang, Z., Lin, D. et al. (2023). Sex‐specific difference in the relationship between body fat percentage and arterial stiffness: Results from Fuzhou study. The Journal of Clinical Hypertension, 25 (3), 286–294. https://doi.org/10.1111/jch.14649

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Published

2024-07-16

How to Cite

Yehorov, K. (2024). Gender differences in the elastic properties of the arterial wall in patients with arterial hypertension during the age-related evolution. ScienceRise: Medical Science, (2(59), 4–13. https://doi.org/10.15587/2519-4798.2024.306857

Issue

No. 2(59) (2024)

Section

Medical Science

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