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Gender differences in the relationship between left ventricular size and ambulatory blood pressure in borderline
O Vriz1, H Lu, P Visentin
1Clinica Medica 1, Padova, Italy.
Insights
Gender differences exist in how young adults with mild hypertension adapt their hearts. In women, blood pressure significantly impacts heart structure, unlike in men, where body weight is the primary factor.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Clinical Cardiology
Background:
- Young adults with borderline to mild hypertension require assessment for cardiac adaptation.
- Understanding gender-specific responses to elevated blood pressure is crucial for early intervention.
Purpose of the Study:
- To investigate potential gender differences in cardiac adaptation to raised blood pressure levels.
- To identify predictors of left ventricular changes in young hypertensive men and women.
Main Methods:
- A cohort of 499 stage I hypertensive subjects (18-45 years) underwent ambulatory blood pressure monitoring, echocardiography, and 24-h urinary catecholamine measurements.
- Subjects were stratified by daytime systolic blood pressure quartiles, with separate analyses for men and women.
- Multiple regression analysis was used to determine predictors of left ventricular parameters.
Main Results:
- In men, no left ventricular parameters differed across blood pressure quartiles; body weight was the main predictor.
- In women, left ventricular mass, posterior wall, and interventricular septum thickness increased with rising systolic blood pressure.
- Daytime systolic blood pressure was a key determinant of left ventricular mass and geometry in women, while body weight predicted mass and diameter.
Conclusions:
- Daytime systolic blood pressure is the primary determinant of left ventricular mass and geometry in pre-menopausal women with stage I hypertension.
- In contrast, body weight is the main predictor of left ventricular dimensional indices in men with similar hypertensive profiles.
Aim:
To assess whether the are gender differences in cardiac adaptation to raised blood pressure levels in young subjects with borderline to mild hypertension.
Methods And Results:
In 499 18-45-year-old stage I hypertensive subjects (377 men and 122 women) with a mean age of 33 +/- 9 years and office blood pressure of 146 +/- 11/ 94 +/- 6 mmHg, ambulatory blood pressure monitoring in duplicate, echocardiography and 24-h urinary catecholamines measurement were performed.
Results:
The whole group was divided into quartiles of increasing daytime blood pressure and differences in left ventricular echocardiographic data were analysed in the two sexes separately. In men no left ventricular parameter differed across the quartiles, while in women left ventricular mass, posterior wall thickness and interventricular septum thickness showed a clear tendency to increase with increasing levels of systolic blood pressure. In multiple regression analysis, daytime systolic blood pressure explained only a small fraction of the variance in left ventricular parameters in men, while in women daytime systolic blood pressure was a main determinant of left ventricular mass and posterior wall and septal thicknesses. Body weight explained most of the variance in all dimensional parameters in men. In women weight was an important predictor of left ventricular mass and diameter, but was unrelated to left ventricular posterior wall and septal thicknesses.
Conclusions:
Daytime systolic blood pressure is the most important predictor of left ventricular mass and geometry in pre-menopausal women with stage I hypertension, while in men left ventricular dimensional indices are chiefly explained by body weight.
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