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Factors Driving High Blood Pressure Differ by Gender

Written by Shin, J
Monday, 15 January 2018

The factors that drive blood pressure in middle age differ in men and women, suggesting that gender-specific treatments for hypertension may be of benefit [1].


An increase in any one of the three factors that determine blood pressure—heart rate, stroke volume, and total peripheral resistance—can lead to an increase in blood pressure. The key takeaway from this study is that, for young and middle-aged women, stroke volume was the main determinant of blood pressure, while, in men, vascular resistance was the main determinant of blood pressure. The study was presented at the 2017 American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions.


Authors studied 1347 Canadians from the Saguenay Youth Study, including 911 adolescents 12 to 18 years old (52% female) and 426 young to middle-aged adults 36 to 65 years old (56% female). Beat-by-beat systolic BP (SBP) and diastolic BP (DBP), together with heart rate, stroke volume, and total peripheral resistance were measured with a Finometer (Finapres Medical Systems) throughout a 52-minute protocol designed to mimic daily-life activities, such as changes in posture and mental stress.


The relative contributions of stroke volume, total peripheral resistance, and heart rate to SBP and DBP showed "marked sex differences. In females, stroke volume explained 55% of the variance in SBP vs. only 35% in males. In males, the major determinant of SBP was total peripheral resistance, which explained 47% of the variance, vs. only 30% in females. These gender differences were seen across most of the 52-minute protocol, being most prominent during standing and least evident during mental stress.



References


Shin, J, et al. Sex differences in relative contributions of hemodynamic parameters to blood pressure. 2017 AHA Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions. September 15, 2017; San Francisco, CA. Abstract 17-HBPR-A-668-AHA.