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. 2025 Jun;13(12):e70413.
doi: 10.14814/phy2.70413.

Age and sex differences in blood pressure regulation: A focus on the vascular baroreflex limb

Darcianne K Watanabe  1 , Suzi Hong  2 , DeWayne P Williams  3 , Jordan Kohn  2 , Julian Koenig  4 , Gustavo A Reyes Del Paso  5 , Julian F Thayer  3
Affiliations

Age and sex differences in blood pressure regulation: A focus on the vascular baroreflex limb

Darcianne K Watanabe et al. Physiol Rep. 2025 Jun.

Abstract

Despite the vasculature's role in long-term blood pressure (BP) regulation, limited work exists on vascular baroreflex function. This study focused on hypothesized age and sex differences in the vascular-sympathetic baroreflex limb and explored the role of hormone replacement therapy (HRT). Resting cardiac and hemodynamic measures were recorded. Baroreflex sensitivity (BRS) and baroreflex effectiveness (BEI) were calculated for each baroreflex limb (cardiac, myocardial, and vascular). In younger adults, women had significantly lower SBP, total peripheral resistance (TPR), and vascular-BEI than men (r's > 0.245, p's < 0.012). In older adults with managed-hypertension, post-menopausal women had significantly higher SBP, TPR, and vBEI, than men (r's > 0.228, p's < 0.018), while younger women had significantly higher vBRS (r's > 0.199, p's < 0.027) and lower TPR (r's > 0.281, p's < 0.002). Younger men showed significantly higher vascular-BRS and vascular-BEI (r's > 0.318, p's < 0.002), higher TPR and TPR-variability (r's > 0.314, p ≤ 0.003), and lower SBP (r's > 0.295, p's < 0.005) than older men. Compared to non-HRT women, HRT-women had only significantly lower SBP (r = 0.243, p = 0.035). We provide the first evidence of age and sex differences in vascular baroreflex-mediated BP control using the sequence method.

Keywords: hemodynamics of blood pressure; hormone replacement therapy; hypertension; total peripheral resistance; vascular baroreflex sensitivity.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Depict mean differences between younger and older adults in systolic blood pressure in millimeters of mercury (SBP; a) and total peripheral resistance in dynes per second per centimeter cubed (TPR; b) stratified by sex, with standard error bars.
FIGURE 2
FIGURE 2
Depict mean differences between younger and older adults in baroreflex sensitivity in the vascular baroreflex limb in dynes per second per centimeter cubed per millimeters of mercury (vBRS; a) and baroreflex effectiveness in the vascular baroreflex limb in % (vBEI; b) stratified by sex, with standard error bars.
FIGURE 3
FIGURE 3
Depict mean differences between women not on HRT (NonHRT women), women on HRT (HRT women), and older men in systolic blood pressure in millimeters of mercury (SBP; a) and total peripheral resistance dynes per second per centimeter cubed per mmHg (TPR; b), with standard error bars.
FIGURE 4
FIGURE 4
Depict mean differences between women not on HRT (NonHRT women), women on HRT (HRT women), and older men in baroreflex sensitivity in the vascular baroreflex limb in dynes per second per centimeter cubed per millimeters of mercury (vBRS; a) and baroreflex effectiveness in the vascular baroreflex limb in % (vBEI; b), with standard error bars.
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