Women with arterial hypertension developing orthostatic hypertension exhibited greater increases in peripheral vascular resistance (22.27% vs 12.79%) and heart rate (18.22% vs 14.32%) than men.
Observational (n=110)
Are there gender differences in hemodynamic responses and metanephrine levels during an orthostatic test in patients with arterial hypertension who develop orthostatic hypertension?
Women with arterial hypertension who develop orthostatic hypertension exhibit a more pronounced hemodynamic response to orthostatic stress than men, suggesting increased adrenergic receptor activity rather than higher sympathetic tone.
Absolute Event Rate: 22.27% vs 12.79%
Objective: Evaluation the character of cardiovascular indices changes in men and women with arterial hypertension developing orthostatic hypertension as well as the level of metanephrine during orthostatic test. Design and method: Study enrolled 31 men and 24 women with arterial hypertension (HTN) of 1st degree who were exposed to orthostatic test. After 1 min indices of peripheral hemodynamics and blood levels of metanephrine were assayed, compared with before test values. Likewise, a control series was formed by 31 men and 24 women with HTN which developed orthostatic arterial hypotension. Results: During the test, women showed greater increases in blood pressure indices than men: systolic (15.18 vs 14.32%), diastolic (13.37 vs 12.77%), and mean arterial pressure (14.42 vs 13.46%). In controls these indices decreased in a range of 7.71-17.74% during test. In this regard it is important to underline that heart rate increment was higher in women than men: 18.22% (median 15b/min) vs 14.32% (median 11b/min), while in controls the increase did not exceed 10.51%. Likewise, it is notable the higher level of peripheral vascular resistance enhancement in women compared to men: 22.27% vs 12.79%, despite similar baseline values. In control series increasing rate of this index was negligible (0.9-1.9%). Increase of peripheral vascular resistance during test correlated with conduit arteries compliance fall according to dynamics of elasticity index diminution, which was more considerable in women: 46.81 vs 15.54%. Decrease of small arteries compliance was similar. Metanephrine levels were similar before the test in both series (from 1.88 up to 2.14 nM/L), and increased similarly after it (19.3-21.5%), remaining slightly higher in patients with orthostatic hypertension, and without gender differences. Conclusions: Among patients with arterial hypertension developing orthostatic hypertension women were more receptive, manifested by a higher increase of blood pressure indices, heart rate, peripheral vascular resistance, and a bigger diminution of conduit artery compliance compared to men. Since metanephrine, a marker of sympathetic activity, had a similar elevation level during test like control and showed no gender differences might be suggested the increased adrenergic receptor activity in patients with orthostatic hypertension, particularly in women.
Stela Dodu (Fri,) conducted a observational in Arterial hypertension (n=110). Female sex vs. Male sex was evaluated on Increase in peripheral vascular resistance during orthostatic test. Women with arterial hypertension developing orthostatic hypertension exhibited greater increases in peripheral vascular resistance (22.27% vs 12.79%) and heart rate (18.22% vs 14.32%) than men.