Gender differences in aortic blood pressure, arterial stiffness, and cerebral blood flow in healthy adults: A STROBE-compliant cross-sectional observational study

Abstract

Understanding gender-specific differences due to anatomical and physiological variations in cardiovascular and cerebrovascular physiology is essential. Thus, this study explores variations in aortic and blood pressure, arterial stiffness, and cerebral blood flow between healthy men and women. The study involved 36 healthy participants (23 males and 13 females). Aortic blood pressure (aBP) and arterial stiffness were assessed using pulse wave analysis and pulse wave velocity, respectively, via Vicorder® software. Cerebral blood flow in the middle cerebral artery, internal carotid artery (ICA), and common carotid artery (CCA) was evaluated using high-resolution ultrasound, with automated edge-detection software used for ICA and CCA diameter measurements. Males showed significantly higher aBP and arterial stiffness compared to females (systolic aBP mean difference [MD] + 15.74 mm Hg, P < .001; diastolic aBP MD + 6.57 mm Hg, P = .01; arterial stiffness MD + 1.01 m/s, P < .001). In contrast, CCA peak systolic velocity (CCA-PSV) was significantly higher (MD + 0.20 m/s, P = .001) in males compared to females, with no significant differences were observed in middle cerebral artery-PSV (P = .10) nor ICA-PSV (P = .99). Males also had a larger CCA diameter (MD + 0.45 mm, P = .01) and ICA diameter (MD + 0.41 mm, P = .05). The findings of this study showed significant gender differences in aBP, arterial stiffness, and characteristics of the extracranial arteries. The observed of higher central BP and arterial stiffness, along with elevated CCA peak systolic velocity and larger CCA and ICA diameters combination in healthy males, suggests a compensatory mechanism that may help preserve cerebral perfusion in the presence of increased blood pressure and arterial stiffness. These highlight the importance of considering gender-specific cardiovascular and cerebrovascular responses in clinical assessments and interventions.

Keywords: aortic blood pressure; arterial stiffness; cardiovascular system; cerebral blood flow; gender differences.

Figure 1.

Differences in aortic blood pressure (aBP), brachial blood pressure (bBP), and arterial stiffness between males and females. Systolic aBP (A), diastolic aBP (B), systolic bBP (C), diastolic bBP (D), arterial stiffness through pulse wave velocity (PWV, E). *P ≤ .05 using independent t test.

Figure 2.

Differences in cerebral blood flow velocities between males and females. Common carotid artery peak systolic velocity (CCA-PSV, A), internal carotid artery peak systolic velocity (ICA-PSV, B), and middle cerebral artery peak systolic velocity (MCA-PSV, C) (mean ± SD). *P ≤ .05 using independent t test.

Figure 3.

Differences in common carotid artery diameter (CCA-D, A) and internal carotid artery diameter (ICA-D, B) between males and females. *P ≤ .05 using independent t test.