title: Gender-related difference in arterial elastance during exercise in patients with hypertension.
abstract: Exercise intolerance and heart failure with preserved ejection fraction are common in females. Recently, arterial stiffness has been suggested to be a significant contributor in the development of heart failure. How gender difference affects arterial stiffening and its response to exercise is not well known. We hypothesized that arterial elastance index during exercise would be more abnormal in females with hypertension than males. Arterial elastance index was estimated as arterial end systolic pressure/stroke volume controlled for body surface area and was measured at rest and during graded supine bicycle exercise (25 watts, 3-minute increments) in 298 patients with hypertension (149 males; 149 females; mean age, 59). The subjects were divided into 2 groups by gender. Exercise duration was significantly shorter in females compared to males (692+/-222 versus 483+/-128 seconds, P<0.001). Although arterial elastance index at baseline was significantly higher in males, the magnitude of increase was steeper in females with the magnitude of change at 75 W of exercise being significantly higher in females compared to males (0.69+/-0.83 versus 0.43+/-0.69, P=0.018). Arterial elastance index at each stage of exercise up to 75 W was independently associated with decreased exercise duration. In conclusion, despite lower arterial elastance index at rest, the increase during exercise was steeper in women with hypertension, suggesting a gender-related difference in dynamic arterial stiffness. The arterial elastance index during exercise was significantly associated with exercise duration in patients with hypertension.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul, Korea 120-752.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Jin-Mi
authors.initials: JM
authors.lastname: Kim
authors.forename: Jeong-Ah
authors.initials: JA
authors.lastname: Ahn
authors.forename: Se-Wha
authors.initials: SW
authors.lastname: Lee
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D000368:Aged; D001158:Arteries / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D015150:Echocardiography, Doppler; D004548:Elasticity; D015444:Exercise / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D013318:Stroke Volume / Q000502:physiology