Sex difference in cardiovascular risk: role of pulse pressure amplification.
J Am Coll Cardiol
; 59(20): 1771-7, 2012 May 15.
Article
em En
| MEDLINE
| ID: mdl-22575315
ABSTRACT
OBJECTIVES:
The study was to explore whether the brachial/carotid pulse pressure (B/C-PP) ratio selectively predicts the sex difference in age-related cardiovascular (CV) death.BACKGROUND:
Hypertension and CV complications are more severe in men and post-menopausal women than in pre-menopausal women. C-PP is lower than B-PP, and the B/C-PP ratio is a physiological marker of PP amplification between B and C arteries that tends toward 1.0 with age.METHODS:
The study involved 72,437 men (ages 41.0 ± 11.1 years) and 52,714 women (39.5 ± 11.6 years). C-PP was calculated for each sex by a multiple regression analysis including B-PP, age, height and risk factors, and a method validated beforehand in a subgroup of 834 subjects. During the 12 years of follow-up, 3,028 men and 969 women died.RESULTS:
In the total population, the adjusted hazard ratios (HR) (95% confidence interval [CI]) of B/C-PP ratio were 1) for all-cause mortality men, HR 1.51 (95% CI 1.47 to 1.56), women; HR 2.46 (95% CI 2.27 to 2.67) (p < 0.0001); and 2) for CV mortality men, HR 1.81 (95% CI 1.70 to 1.93); women, HR 4.46 (95% CI 3.66 to 5.45) (p < 0.0001). The B/C-PP impact on mortality did not significantly increase from younger men to those ≥ 55 years of age, from HR 1.44 (95% CI 1.31 to 1.58) to HR 1.65 (95% CI 1.48 to 1.84), but increased significantly with age in women HR 3.19 (95% CI 2.08 to 4.89) versus HR 5.60 (95% CI 4.17 to 7.50) (p < 0.01). Thus, the mortality impact of B/C-PP ratio was 3-fold higher in women than in men ≥ 55 years old.CONCLUSIONS:
PP amplification is highly predictive of differences in CV risk between men and women. In post-menopausal women, the attenuation of PP amplification, mainly related to increased aortic stiffness, contributes to the significant increase in CV risk.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Doenças Cardiovasculares
/
Caracteres Sexuais
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
França