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Published on: May 3, 2018
Sex differences in blood pressure variability in office, home and ambulatory measurements
Marek Stopa1,2, Katarzyna Zięba3, Anna Tofilska3
11st Department of Cardiology and Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.
Insights
Women show higher blood pressure variability (BPV) than men, even with lower blood pressure. This variability is linked to organ damage, emphasizing the need for integrated management of risk factors and lifestyle changes.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Clinical Diagnostics
Background:
- Hypertension is a major cardiovascular disease risk factor.
- Blood pressure variability (BPV) is increasingly recognized alongside blood pressure levels.
- Understanding BPV determinants is crucial for cardiovascular health.
Purpose of the Study:
- To compare factors influencing blood pressure variability (BPV) in men and women.
- To analyze BPV in both office and out-of-office settings.
- To investigate the relationship between BPV and subclinical organ damage.
Main Methods:
- Recruited 120 women and 99 men for outpatient study.
- Utilized attended and unattended office BP measurements.
- Employed 24-hour ambulatory BP monitoring and 7-day home BP monitoring.
- Conducted laboratory tests, echocardiography, and carotid artery ultrasound.
Main Results:
- Higher BPV observed in women, older patients, diabetics, and smokers.
- Female sex was a significant determinant of higher BPV (P = 0.002) after adjustments.
- BPV correlates with subclinical organ damage, more strongly in women.
Conclusions:
- Women exhibit elevated BPV despite lower blood pressure.
- BPV is a multifaceted phenomenon linked to organ damage.
- Integrated interventions targeting BP, metabolic factors, and lifestyle are essential for reducing BPV.
Background:
Hypertension is widely recognized as a significant risk factor for cardiovascular diseases. Beyond merely focusing on blood pressure levels, there is growing recognition of the importance of considering blood pressure variability (BPV).
Aims:
The aim of this study was to compare factors influencing BPV in men and women in office and out-of-office measurements.
Methods:
The study enrolled 120 women and 99 men recruited from an outpatient clinic between 2021 and 2022. All participants underwent a medical interview. Subsequently, office blood pressure measurements were conducted using two methods - unattended and attended measurements Following this, 24-hour ambulatory blood pressure monitoring was performed, and participants were instructed to conduct home blood pressure measurements for 7 days. Laboratory tests, echocardiography and carotid artery ultrasound were performed thereafter.
Results:
BPV was higher in women, in older patients, those with diabetes and smokers. Female sex remained significant determinant of higher BPV in multiple regression analysis (b = -0.299; P = 0.002) after adjustment for age (b = 0.247; P = 0.01), body mass index (b = 0.012; P = 0.89), diabetes (b = -0.155; P = 0.08), smoking (b = 0.063; P = 0.48) and blood pressure values (b = 0.478; P <0.001). BPV is associated with parameters of subclinical organ-damage and this relationship is stronger for women than men.
Conclusions:
Women exhibit higher BPV despite having lower blood pressure. Reducing the BPV, a multifaceted phenomenon related to organ damage, necessitates integrated intervention focused on optimizing blood pressure values on one hand, and managing metabolic risk factors and lifestyle modifications, notably including tobacco cessation, on the other.
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