Sex differences in left ventricular function in older persons with mild hypertension.
BACKGROUND
Epidemiologic studies suggest that women are at increased risk of developing heart failure secondary to hypertension. Other studies have documented sex differences in left ventricular systolic and diastolic function in the presence of pressure overload states such as seen in aortic stenosis and hypertension. It is less clear if sex differences are present among older persons with mild hypertension.


METHODS
One hundred seven healthy subjects, aged 55 to 75 years, with blood pressures ranging from 130 to 159 mm Hg systolic and/or 85 to 99 mm Hg diastolic, were examined by standard echocardiography and the newer modalities of tissue Doppler and color M-mode imaging.


RESULTS
Women had a lower peak mitral annular systolic velocity (Sm), 8.9 (95% CI 8.4-9.5) cm/s versus 10.2 (95% CI 9.6-11.0) cm/s, (P < .01) than men. Among women, increasing age was associated with a reduction in diastolic function. For every decade of age, peak early mitral annular diastolic velocity (Em) declined by 1.6 cm/s (P < .01), mitral inflow velocity of propagation (Vp) declined by 26% (P < .01), E/Vp ratio increased by 20% (P = .03), and E/Em ratio increased by 11% (P = .04) in women. No age-associated changes were seen in men.


CONCLUSIONS
As revealed by newer echocardiographic imaging modalities, women with mild hypertension showed greater reductions in systolic and diastolic function as they aged compared with men. Our findings are consistent with the increased risk older women have of developing heart failure because of hypertension.
Lim
Jimmy G
JG
Division of Cardiology, Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD, USA.
Shapiro
Edward P
EP
Vaidya
Dhananjay
D
Najjar
Samer S
SS
Turner
Katherine L
KL
Bacher
Anita C
AC
Ouyang
Pamela
P
Stewart
Kerry J
KJ
D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012727:Sex Characteristics; D016277:Ventricular Function, Left