Aortic wave reflection in women and men

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Hypertension Research

Background:

• Augmentation index (AIx) quantifies aortic wave reflections (AWRs), influenced by wave magnitude and return time.
• Sex differences in AIx may relate to body size or pulse pressure (PP) amplification (brachial PP-to-carotid PP ratio, B/C).

Purpose of the Study:

• To quantify AWRs using a novel triangulation method.
• To determine sex differences in AWRs and their relationship to AIx, body size, and PP amplification in hypertensive patients.

Main Methods:

• Pulse wave analysis to evaluate AWRs in 51 women and 72 men with hypertension.
• Assessment of AIx, B/C ratio, reflection magnitude, and backward pressure wave characteristics.
• Statistical analysis adjusted for age, blood pressure, heart rate, pulse wave velocity, body height, and B/C ratio.

Main Results:

• Women exhibited significantly higher AIx (adjusted for heart rate) compared to men.
• Women showed a decreased B/C ratio and increased reflection magnitude and backward pressure wave amplitude, but not timing.
• The amplitude difference was significant after heart rate or pulse wave velocity adjustment, but abolished after body height or B/C ratio adjustment.

Conclusions:

• Hypertensive women have increased AIx, primarily due to enhanced backward pressure wave amplitude, not altered timing.
• These sex differences are associated with body size and brachial-carotid PP amplification, factors linked to cardiovascular risk differences.