Early abnormalities of arterial distensibility in premenopausal women screened for stage 1 hypertension

Purpose: Aim of this study was to investigate and compare several parameters of arterial distensibility between a group of hypertensives premenopausal women and a group of hypertensive male peers. Methods: We studied 385 stage 1 hypertensives subjects (280 men and 105 women), from the HARVEST study (mean age 38±10 years). Arterial distensibility was evaluated by applanation tonometry. Between-gender differences were adjusted for several confounders, patient were divided into 3 age classes and differences in arterial distensibility parameters were examined with a 2-way ANCOVA using sex and age-class as factors. Results: Despite better metabolic profile and lower systolic blood pressure (BP), women showed lower large (C1) and small artery (C2) compliance, higher augmentation index (AIx) and total peripheral resistance (TPR) than men (all age-adjusted p<0.0001); pulse wave velocity (PWV) did not differ between the two genders. When data were adjusted for BP and heart rate (HR), lifestyle habits and metabolic parameters, differences remained highly significant (p<0.0001). However, when height was included in the models, only the differences in C2 and AIx remained significant (p=0.033 and p=0.001, respectively). Other significant determinants of distensibility were: systolic BP and HR for C1 and C2, BMI and age for C2 and AIx, and sedentariness for Aix. The gender-related differences in distensibility parameters did not vary across the age classes, with no significant interaction between age and sex. In both genders C2 and AIx were closely correlated with TPR (all p<0.001). Conclusions: These data show that height accounts for most of the difference in arterial distensibility parameters between hypertensive men and women. However, after adjustment for height, impairment of C2 and AIx persist in premenopausal hypertensives women, indicating an higher TPR condition.