Female Gender Is Associated with Higher Susceptibility of Weight Induced Arterial Stiffening and Rise in Blood Pressure

Abstract

Arterial stiffness is an important predictor of cardiovascular events, independent of traditional risk factors. Stiffening of arteries, though an adaptive process to hemodynamic load, results in substantial increase in the pulsatile hemodynamic forces that detrimentally affects the microcirculation perfusing the vital organs such as the brain, heart and kidneys. Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity. Our study sought to determine the gender-based effects on arterial stiffening in obesity which may predispose to the development of hypertension. We found female sex is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure in obesity. Women had significantly higher carotid-femoral pulse wave velocity (CF-PWV) with higher body mass index (BMI) status (normal: 7.9 ± 2 m/s; overweight: 9.1 ± 2 m/s; obese: 9 ± 2 m/s, p < 0.001), whereas it was similar in males across all BMI categories. The linear association between arterial stiffness and BMI following adjustment for age and brachial systolic and diastolic blood pressure (BP), remained significant in females (β = 0.06; 95% CI 0.01 to 0.1; p < 0.05) but not in males (β = 0.04; 95% CI −0.01 to 0.1; p > 0.05). The mean CF-PWV values increased by 0.1 m/s for every 1 kg/m2 increase in BMI in the female subjects in the age adjusted linear model, while such effect was not seen in the male subjects. In line with arterial stiffening, the overweight and obese females demonstrated significantly higher systolic brachial BP. (BP difference: ΔBP 9−11 mmHg, p < 0.01) and central systolic pressure (ΔBP 8−10 mmHg, p < 0.05) compared to their lean counterparts, unlike the male subjects. Our results suggest that female gender is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure.

Association between Brachial-Ankle Pulse Wave Velocity as a Marker of Arterial Stiffness and Body Mass Index in a Chinese Population

“…A major limitation of our study is that females were under-represented, only comprised about 27.5% of the total study population, and only 7% of them were in overweight or obese. However, the results are consistent with our findings previously published [ 25 ], showing that overweight and obese females are more susceptible to weight-related hypertension associated with faster degeneration of the elastic arteries. Furthermore, the current study was an observational study and did not examine the effect of a greater BMI on endpoint events.…”

“…Besides analyzing the whole cohort, we hypothesized that some features related to different class of BMI might be partly associated with sex, as we previously reported [ 25 ]; thus, we also grouped and further analyzed males and females separately.…”

“…Further, the practice of classification based on BMI may not distinguish body shape or body fat distribution [ 24 ]. While obesity has been known to affect both sexes, it is apparent that females who are overweight or obese have a higher susceptibility to weight-related stiffening of the arteries associated with hypertension [ 25 ], hence increased CVD risk [ 26 ].…”

Arterial Stiffness, Biomarkers of Liver Fat, and the Development of Metabolic Dysfunction in Metabolically Healthy Population: A Prospective Study

“…Our findings were consistent with a cross-sectional study ( 13 ) that also indicated that individuals with overweight/obesity, instead of those with normal weight, had significant associations between elevated baPWV levels and diabetes risk. Another study revealed that women had higher susceptibility of arterial stiffening in obesity which predispose to hypertension ( 31 ). However, there was evidence showing a lower degree of stiffness in large arteries of overweight-obese subjects compared to their normal-weight counterparts ( 32 ).…”

Diabetes Affects the Relationship between Heart Rate Variability and Arterial Stiffness in a Gender-Specific Manner

“…Gender differences have been reported for several conditions affecting arterial stiffness and/or the autonomic control of the heart: BP [ 6 , 22 ] and heart rate variability [ 23 ], walking speed [ 24 ], insulin resitance [ 25 ], and body weight and shape [ 26 , 27 ].…”