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Sex differences in excess and reservoir arterial blood pressures as markers of phenotype

Guzik, Przemyslawa; Schneider, Agataa; Piskorski, Jaroslawb,c; Klimas, Krzysztofa; Krauze, Tomasza; Marciniak, Ryszardd; Minczykowski, Andrzeja; Mihailidou, Anastasia S.e,f,*; Wykretowicz, Andrzeja,*

doi: 10.1097/HJH.0000000000002135
ORIGINAL PAPERS: Epidemiology
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Objectives: Excess pressure and reservoir pressure are related to various clinical outcomes in cardiovascular diseases, but whether there are sex differences in healthy individuals remains uncertain. We compared phenotypes of excess pressure and reservoir pressure between healthy men and women.

Methods: Different features of noninvasively recorded radial and reconstructed aortic pressure waveforms were measured in 435 healthy adults (257 women, 59%). In addition to SBP and DBP, we compared values of maximal excess pressure and reservoir pressure (RPMAX), excess pressure and reservoir pressure time integrals, respectively, as well as relative contributions of excess pressure (EPREL) and reservoir pressure to total blood pressure time integral, respectively, between men and women divided in two age categories, below 51 (82 women and 66 men) and greater than or equal to 51 years old (175 women and 112 men), corresponding to average age of menopause for women and acceleration of vascular ageing for all.

Results: In both age categories, compared with men, women had significantly lower peripheral and aortic SBP and DBP. Analysis of covariance adjusted for BMI revealed that women who were greater than or equal to 51 years old had significantly higher excess pressure time integral, RPMAX, reservoir pressure time integral, EPREL, and relative contributions of reservoir pressure than men in the same age category. In the younger age category below 51 years old, EPREL and RPMAX were also significantly higher in women than men.

Conclusion: Our study shows that healthy women have lower peripheral and aortic SBP and DBP compared with healthy men; however, their excess and reservoir pressures are higher, particularly after 51 years of age.

aDepartment of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, Poznan

bDivision of Material and Medical Physics, Institute of Physics

cFaculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora

dDepartment of Medical Education, Poznan University of Medical Sciences, Poznan, Poland

eDepartment of Cardiology and Kolling Institute, Royal North Shore Hospital

fMacquarie University, Sydney, New South Wales, Australia

Correspondence to Przemyslaw Guzik, MD, PhD, FESC, ISHNE Fellow, Department of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, 49 Przybyszewskiego, 60-355 Poznan, Poland. Tel: +48 618691391; fax: +48 618691689; e-mail: pguzik@ptkardio.pl

Abbreviations: ANCOVA, analysis of covariance; DBPTI, pressure time integral of DBP; EPMAX, peak excess pressure; EPREL, relative contribution of excess pressure time integral to the time integral of the total pressure waveform; EPTI, time integral of excess pressure; HR, heart rate; MBP, mean blood pressure; np, not possible to calculate; PP, pulse pressure; RPMAX, peak reservoir pressure; RPREL, relative contribution of reservoir pressure time integral to the time integral of the total pressure waveform; RPTI, time integral of reservoir pressure; TBPTI, time integral of the total pressure waveform

Received 15 November, 2018

Revised 12 March, 2019

Accepted 29 March, 2019

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