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Hemodynamic and hormonal patterns of untreated essential hypertension in men and women

Carlos M Ferrario1, Jewell A Jessup, Ronald D Smith

  • 1Laboratory of Translational Hypertension Research, Department of Surgery, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA.

Therapeutic Advances in Cardiovascular Disease
|November 28, 2013
PubMed

Insights

Men and women show distinct hemodynamic and hormonal profiles contributing to hypertension. Understanding these sex differences is crucial for personalized blood pressure management and effective treatment strategies.

Area of Science:

  • Cardiovascular Physiology
  • Hypertension Pathophysiology
  • Endocrinology

Background:

  • Hemodynamic factors are critical for understanding hypertension development and tailoring treatments.
  • Limited data exist on sex-specific hemodynamic contributions to hypertension progression in prehypertension stages I and II (JNC-7 guidelines).

Purpose of the Study:

  • To investigate sex differences in hemodynamic and hormonal profiles of patients with untreated hypertension.
  • To identify distinct mechanisms underlying elevated blood pressure in men versus women.

Main Methods:

  • Noninvasive impedance cardiography and applanation tonometry were used.
  • Plasma and serum levels of angiotensin II, angiotensin (1-7), aldosterone, hs-CRP, and cytokines were measured.
  • 100 patients with untreated hypertension (39 women) were characterized.

Main Results:

  • Men exhibited lower pulse pressure, systemic vascular resistance, and arterial stiffness markers compared to women.
  • Elevated blood pressure in men was linked to increased stroke volume and cardiac output, unlike in women.
  • Women showed higher plasma leptin, hs-CRP, angiotensin II, and aldosterone; hs-CRP correlated with TGFβ1 and body weight in women.

Conclusions:

  • Sex differences in hemodynamic and hormonal mechanisms contributing to elevated arterial pressure are significant but poorly characterized.
  • These sex-specific differences in hypertension mechanisms may impact therapeutic choices.
  • This study highlights the need for sex-specific considerations in managing essential hypertension.
Abstract

Keywords:
angiotensin IIblood pressurecardiac outputcentral aortic pressureessential hypertensioninflammationvascular disease

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