Abstract 156: Gender Differences Related to Increased Vascular Age in Hypertensive Patients
Background: Vascular age (VA) has been increasingly considered in the evaluation of hypertensive patients but the gender differences have not established yet.
Objective: To characterize gender differences in clinical and vascular parameters in treated hypertensive patients with increased vascular age.
Methods: A cross-sectional study was carried out to evaluate hypertensive patients on stable drug therapy, both genders, aged 30-74 years. Blood pressure (BP) was measured and ultrasonography was performed to evaluate brachial flow-mediated dilation (FMD). Carotid-femoral pulse wave velocity (cfPWV) was obtained by Complior SP and normalized by mean BP (cfPWV-N). The 10-year risk for general cardiovascular disease from Framingham Heart Study was used to calculate VA. The median of VA was 76 years, and the study population was divided into four groups: women with lower vascular age (LVA, < 76 years, n=50) or higher vascular age (HVA, ≥ 76 years, n=82), men with LVA (n=26) or HVA (n=27).
Results: Mean age was similar between men and women with HVA (62±5 vs 60±6 years) and with LVA (49±8 vs 51±8 years). LVA men presented greater systolic BP (143±15 vs 132±16 mmHg, p<0.01) compared to LVA women, but no difference between gender was observed in HVA groups (154±15 vs 152±17 mmHg) and diastolic BP was similar in LVA (88±10 vs 88±13 mmHg) and in HVA (89±10 vs 92±14 mmHg) groups. Men with HVA presented greater cardiovascular risk (31±2 vs 18±6 %, p<0.001), cfPWV (12±2 vs 10±2 m/s, p<0.05), cfPWV-N (11±2 vs 9±2 m/s, p<0.05) compared to HVA women. FMD was significantly reduced in HVA women compared to LVA group (11±7 vs 6±5 %, p<0.01), but no significant difference was noted in men due to reduced values even in LVA group (8±5 vs 6±5 %). There was a stronger correlation of vascular age to systolic BP in women (r=0.56, p<0.001) than in men (r=0,30, p<0.05) although the correlation to cfPWV was stronger in men (r=0.45 and r=0.30, p<0.01 for both). On the other hand, VA was inversely correlated to brachial FMD only in women (r=-0.28, p<0.05).
Conclusion: In this population of treated hypertensive patients, men seem to develop endothelial dysfunction earlier than women, and vascular stiffness is more exacerbated in men with higher vascular age, showing more advanced vascular disease in this gender.
- © 2012 by American Heart Association, Inc.