Changes in hemodynamics associated with metabolic syndrome are more pronounced in women than in men

Abstract

The increase in cardiovascular risk associated with metabolic syndrome (MS) seems higher in women than in men. We examined hemodynamics during head-up tilt in 252 men and 250 women without atherosclerosis, diabetes, or antihypertensive medication, mean age 48 years, using whole-body impedance cardiography and radial pulse wave analysis. MS was defined according to Alberti et al. 2009. Men and women with MS presented with corresponding elevations of systolic and diastolic blood pressure (10-14%, p ≤ 0.001) versus controls. Supine pulse wave velocity (16–17%, p < 0.001) and systemic vascular resistance (7–9%, p ≤ 0.026), and upright cardiac output (6–11%, p ≤ 0.008) were higher in both MS groups than controls. Elevation of supine aortic characteristic impedance was higher in women than in men with MS (16% vs. 8%, p = 0.026), and in contrast to men, no upright impedance reduction was observed in women. When upright, women but not men with MS showed faster return of reflected pressure wave (p = 0.036), and smaller decrease in left cardiac work (p = 0.035) versus controls. The faster upright return of reflected pressure, lower upright decrease in left cardiac work, and higher elevation of aortic characteristic impedance may contribute to the greater increase in MS-related cardiovascular risk in women than in men.

Aldosterone-to-renin ratio is related to arterial stiffness when the screening criteria of primary aldosteronism are not met

“…Therefore, the differences in PWV between the ARR quartiles could not be explained by variations in insulin sensitivity. Also the plasma concentrations of uric acid, the levels of which are usually elevated in insulin resistance and metabolic syndrome 23 , were similar in quartiles of ARR.…”

“…The recruitment of the study subjects has previously been described in detail 21 – 23 . All subjects were examined by a physician and routine laboratory analyses for elevated blood pressure (BP) were taken 24 .…”

Infertility and the Risk of Cardiovascular Disease: Findings From the Study of Women’s Health Across the Nation (SWAN)

“…The primary outcome was metabolic syndrome, a validated marker of CVD risk 14 that may be even more pronounced in women 17 . Metabolic syndrome is a well-established cluster of interrelated risk factors that have been shown to be a precursor of cardiovascular disease 18 .…”

Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects

“…The recruitment of the study subjects has been previously described [ 17 – 19 ]. All subjects were examined by a physician, office BP was measured, and laboratory analyses were taken as previously described [ 20 ].…”