title: Gender specific patterns of age-related decline in aortic stiffness: a cardiovascular magnetic resonance study including normal ranges.
abstract: BACKGROUND
  Young females exhibit lower cardiovascular event rates that young men, a pattern which is lost, or even reversed with advancing age. As aortic stiffness is a powerful risk factor for cardiovascular events, a gender difference with advancing age could provide a plausible explanation for this pattern.
  
  
  METHODS
  777 subjects (♀n = 408, ♂n = 369) across a wide range of age (21-85 years) underwent cardiovascular magnetic resonance to assess aortic pulse wave velocity (PWV) and, in addition, aortic distensibility at three levels; 1) ascending aorta (Ao) and 2) proximal descending aorta (PDA) at the level of the pulmonary artery and 3) the abdominal aorta (DDA).
  
  
  RESULTS
  There was a strong negative correlation between increasing age and regional aortic distensibility (Ao♀R-0.84, ♂R-0.80, PDA♀R-0.82, ♂R-0.77, DDA♀R-0.80, ♂R-0.71 all p < 0.001) and a strong positive correlation with PWV, (♀R0.53, ♂R 0.63 both p < 0.001). Even after adjustment for mean arterial pressure, body mass index, heart rate, smoking and diabetes, females exhibited a steeper decrease in all distensibility measures in response to increasing age (Ao♀-1.3 vs ♂-1.1 mmHg-1, PDA ♀-1.2 vs ♂-1.0 mmHg, DDA ♀-1.8 vs ♂-1.4 mmHg-1 per 10 years increase in age all p < 0.001). No gender difference in PWV increase with age was observed (p = 0.11).
  
  
  CONCLUSIONS
  Although advancing age is accompanied by increased aortic stiffness in both males and females, a significant sex difference in the rate of change exists, with females showing a steeper decline in aortic elasticity. As aortic stiffness is strongly related to cardiovascular events our observations may explain the increase in cardiovascular event rates that accompanies the menopausal age in women.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Nethononda
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.forename: Ross
authors.initials: R
authors.lastname: Stewart
authors.forename: Ilias
authors.initials: I
authors.lastname: Kylinterias
authors.forename: Polly
authors.initials: P
authors.lastname: Whitworth
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
authors.forename: Hugh
authors.initials: H
authors.lastname: Watkins
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Rider
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001011:Aorta / Q000503:physiopathology*; D001018:Aortic Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004548:Elasticity; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis / Q000379:methods*; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D059289:Vascular Stiffness; D055815:Young Adult
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