Sex differences in excess and reservoir arterial blood pressures as markers of phenotype.

Objectives: Excess pressure and reservoir pressure are related to various clinical outcomes in cardiovascular diseases, but whether there are sex differences in healthy individuals remains uncertain. We compared phenotypes of excess pressure and reservoir pressure between healthy men and women.

Methods: Different features of noninvasively recorded radial and reconstructed aortic pressure waveforms were measured in 435 healthy adults (257 women, 59%). In addition to SBP and DBP, we compared values of maximal excess pressure and reservoir pressure (RPMAX), excess pressure and reservoir pressure time integrals, respectively, as well as relative contributions of excess pressure (EPREL) and reservoir pressure to total blood pressure time integral, respectively, between men and women divided in two age categories, below 51 (82 women and 66 men) and greater than or equal to 51 years old (175 women and 112 men), corresponding to average age of menopause for women and acceleration of vascular ageing for all.

Results: In both age categories, compared with men, women had significantly lower peripheral and aortic SBP and DBP. Analysis of covariance adjusted for BMI revealed that women who were greater than or equal to 51 years old had significantly higher excess pressure time integral, RPMAX, reservoir pressure time integral, EPREL, and relative contributions of reservoir pressure than men in the same age category. In the younger age category below 51 years old, EPREL and RPMAX were also significantly higher in women than men.

Conclusion: Our study shows that healthy women have lower peripheral and aortic SBP and DBP compared with healthy men; however, their excess and reservoir pressures are higher, particularly after 51 years of age.