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The hemodynamic patterns in hypertensive men and women of different age

P Krzesiński1, A Stańczyk1, G Gielerak1

  • 1Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.

Journal of Human Hypertension
|July 3, 2015
PubMed

Insights

Cardiovascular aging in arterial hypertension shows increased arterial stiffness and impaired heart function, with distinct patterns in men and women. These hemodynamic changes are more pronounced in men, while women experience a

Area of Science:

  • Cardiovascular Physiology
  • Gerontology
  • Hypertension Research

Background:

  • Aging is linked to cardiovascular remodeling, a process accelerated by arterial hypertension (AH).
  • Understanding age-related hemodynamic changes in AH is crucial for targeted interventions.
  • Sex differences in cardiovascular aging patterns within AH require further investigation.

Purpose of the Study:

  • To examine the relationship between hemodynamic profiles and age in patients with AH.
  • To determine the influence of sex on hemodynamic patterns during cardiovascular aging in AH.
  • To elucidate the impact of aging on left ventricular function and arterial load in hypertensive individuals.

Main Methods:

  • Cross-sectional study of 326 patients with AH (mean age 44.3 years).
  • Two-dimensional echocardiography assessed left ventricular diastolic dysfunction (LVDD) and ejection fraction (LVEF).
  • Impedance cardiography (ICG) measured acceleration time index (ACI), velocity index (VI), total arterial compliance (TAC), systemic vascular resistance index (SVRI), and thoracic fluid content (TFC).
  • Statistical analysis involved interquartile age subgroup comparisons (Q1: 19-37, Q2: 38-44, Q3: 45-51, Q4: 52-68 years).

Main Results:

  • Aging correlated with increased LVDD prevalence (Q1 vs Q4: 11.0% vs 24.7%, P=0.023).
  • Aging altered LV systolic performance (ACI: 81.4 vs 64.0 1/100Ωs⁻², P=0.0001; VI: 50.5 vs 42.8 1/1000Ωs⁻¹, P=0.006) but not LVEF.
  • Aging increased afterload (TAC: 2.25 vs 1.87 ml mmHg⁻¹, P=0.0001; SVRI: 2182 vs 2407 dyn·s·m²·cm⁻⁵, P=0.045).
  • A 'U-shaped' age relation was observed for TFC.
  • Hemodynamic trends were more pronounced in men; women exhibited a 'middle-aged delay' in these changes.

Conclusions:

  • Cardiovascular aging in AH involves progressive arterial stiffness and impaired left ventricular function.
  • Thoracic fluid reduction may be a compensatory mechanism to vasoconstriction, but its effectiveness diminishes with age.
  • Distinct cardiovascular aging patterns exist between men and women with arterial hypertension.

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