GENDER DIFFERENCES IN ARTERIAL STIFFNESS IN YOUNG PATIENTS WITH PRIMARY HYPERTENSION

Objective: Influence of sex hormones on regulation of arterial stiffness (AS) include different mechanisms where changes in extracellular matrix, smooth and endothelial cells, and influence on oxidative stress and chronic inflammation are highlighted. In women after puberty AS decreases what confirm selective and fluctuating effect of sex hormones, primarly estrogen. In older men, hypogonadism is associated with incresed AS, while testosterone replacement reduce pulse wave velocity (PWV). Our aim was to analyze difference in central hemodynamic parameters between men and women with stage 1 hypertension. Design and method: This study included 154 patients with the primary hypertnsion (69.5% women, mean age 38.5). In all of them we collected different data and antroplogical paramaters using medical records. Parameters of AS were measured with the office tonometric system (SphygmoCor) and 24h ambulatory blood pressure monitoring system using Mobil-o-Graph and Arteriograph, but also estimated PWV was calculated using validated equation (ePWV). Results: There were no statistically significant gender differences in PWV values measured in the office oCor, measured during 24 hours (using Arteriograph and Mobil-O-Graph), and ePWV. There were no statistically significant gender differences in the values of 24 hours systolic and diastolic central aortic pressure (CAP) (Arteriograph or Mobil-O-Graph). Women had significant higher office CAP Men, on average, had statistically significantly higher amplified pulse pressure (APP) values than women (144.20 vs. 128.94, t = 3.275, p < 0.01), while women had statistically significantly higher office augumentation index (AiX) values (t = -6.118, p < 0.001), as well 24 hours (Mobil- O-Graph (t = -5.940, p < 0.001;Arteriograph (t = -5.580, p < 0.001). Conclusions: Possible explanation of no statistically significant differences in PWV values between men and women is average age of our group. A possible gender difference in AiX can be consequence of the increased reflection of pulse waves, which is increased in women. Longitudinal study should be conducted with monitoring of patients at longer time intervals in order to determine the further hormonal influence on structure of the arteries and for the assesment of total CV risk.