The hemodynamic patterns in hypertensive men and women of different age

Abstract

Aging is associated with cardiovascular remodeling, which can be accelerated in arterial hypertension (AH). The aim of this study was to evaluate the relation between hemodynamic profile and age, as well as to identify the role of sex in hemodynamic patterns of aging in AH. The study comprised 326 patients with AH (mean age: 44.3 years). Two-dimensional echocardiography was performed to evaluate, that is, left ventricular diastolic dysfunction (LVDD) and ejection fraction (LVEF), and ICG to evaluate, that is, acceleration time index (ACI), velocity index (VI), total arterial compliance (TAC), systemic vascular resistance index (SVRI) and thoracic fluid content (TFC). The statistical analysis included interquartile comparison in subgroups of age <19-37 years (Q1), 38-44 years (Q2), 45-51 years (Q3) and 52-68 years (Q4). Aging was associated with: (1) higher prevalence of LVDD (Q1 vs Q4: 11.0% vs 24.7%, P=0.023); (2) altered LV systolic performance-ACI (81.4 vs 64.0 1/100 Ω s(-2), P=0.0001), VI (50.5 vs 42.8 1/1000 Ω s(-1), P=0.006), LVEF (65.4% vs 67.0%, NS); and (3) increased afterload-TAC (2.25 vs 1.87 ml mm Hg(-1), P=0.0001), SVRI (2182 vs 2407 dyn s m(2) cm(-)(5); P=0.045). The 'U-shaped' relation to age was observed for TFC. The above-mentioned hemodynamic trends were more pronounced in men, whereas females presented the 'middle-aged delay'. The influence of aging on cardiovascular system shows in progressive arterial stiffness and impaired left ventricular function. Thoracic fluid reduction may be compensatory to vasoconstriction but its efficiency declines with age. The patterns of cardiovascular aging are different in men and women.