Gender-related difference in arterial elastance during exercise in patients with hypertension

Area of Science:

• Cardiovascular Physiology
• Hypertension Research
• Gender Medicine

Background:

• Heart failure with preserved ejection fraction and exercise intolerance are prevalent in women.
• Arterial stiffness is increasingly recognized as a key factor in heart failure development.
• Gender-specific differences in arterial stiffening and exercise response remain poorly understood.

Purpose of the Study:

• To investigate gender differences in arterial elastance index during exercise in patients with hypertension.
• To test the hypothesis that arterial elastance index is more abnormal in females during exercise compared to males.

Main Methods:

• Assessed arterial elastance index (arterial end systolic pressure/stroke volume adjusted for body surface area) at rest and during graded supine bicycle exercise.
• Recruited 298 hypertensive patients (149 males, 149 females, mean age 59).
• Analyzed gender-based differences in arterial elastance index changes and their association with exercise duration.

Main Results:

• Females had significantly shorter exercise duration than males.
• While males had a higher baseline arterial elastance index, females exhibited a steeper increase during exercise.
• The increase in arterial elastance index up to 75 W of exercise was significantly greater in females and independently associated with decreased exercise duration.

Conclusions:

• Hypertensive women demonstrate a gender-related difference in dynamic arterial stiffness, with a steeper increase in arterial elastance index during exercise compared to men.
• Arterial elastance index during exercise is a significant predictor of exercise duration in hypertensive individuals.
• Findings highlight the importance of considering gender in the assessment of arterial stiffness and exercise capacity in hypertension.