Gender influence on metabolic syndrome's effects on arterial stiffness and pressure wave reflections in treated hypertensive subjects.
BACKGROUND
In hypertensive subjects, aortic stiffness, an independent predictor of cardiovascular (CV) risk, measured from pulse wave velocity (PWV), contributes to enhance augmentation index (AI), a marker of the timing and amplitude of wave reflections. Whether PWV and AI are correlated and reflect CV risk in hypertensive men and women with metabolic syndrome (MS) remains unknown.


METHODS
In a cohort of 613 (364 males) treated hypertensive subjects with and without MS (41% MS) pulse wave analysis was used to determine aortic PWV and carotid AI. CV risk was estimated from standard Framingham equations.


RESULTS
In females, but not in males, aortic PWV was higher in subjects with MS, when compared with those without MS (12.7+/-0.3m/s versus 11.1+/-0.4m/s, p<0.001). This result was independent of age and blood pressure. Only in females AI was independently related to the presence of MS; AI did not differ between subjects with or without MS, both males and females. AI did not correlate with PWV, except in males without MS. The overall CV risk was strongly associated to PWV independently of MS and gender, but AI was associated to CV risk only in males.


CONCLUSIONS
In treated hypertensive subjects, the effect of MS on PWV and AI is modulated by gender. The dissociation between PWV and AI observed in women with MS was due to "blunted" wave reflections. This finding is associated with the fact that PWV, but not AI, was a constant marker of CV risk in subjects with MS, whether men and women.
Protogerou
Athanase D
AD
Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, Paris, France.
Blacher
Jacques
J
Aslangul
Elisabeth
E
Le Jeunne
Claire
C
Lekakis
John
J
Mavrikakis
Myron
M
Safar
Michel E
ME
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D005260:Female; D018056:Hemorheology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000503:physiopathology*; D008875:Middle Aged; D008955:Models, Cardiovascular; D015999:Multivariate Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D014655:Vascular Resistance
D000959:Antihypertensive Agents