Sex difference in sympathetic nervous system activity and blood pressure in hypertensive patients

Abstract

Increased sympathetic nervous system (SNS) activity leads to increased risk of cardiovascular morbidity and mortality. This study investigated whether there were sex differences in SNS activity among Chinese patients with hypertension. Ethnic Chinese non‐diabetic hypertensive patients aged 20–50 years were enrolled in Taiwan. A total of 970 hypertensive patients (41.0 ± 7.2 years) completed the study, 664 men and 306 women. They received comprehensive evaluations including office blood pressure (BP) measurement, 24‐h ambulatory BP monitoring, and 24‐h urine sampling assayed for catecholamine excretion. Compared to women, men were younger, had higher body mass index (BMI), office systolic BP (SBP), office diastolic BP (DBP), 24‐h ambulatory BP, and 24‐h urine catecholamine excretion. In men, 24‐h urine total catecholamine levels were correlated with 24‐h SBP (r = 0.103, p = .008) and 24‐h DBP (r = 0.083, p = .033). In women, however, there was no correlation between 24‐h urine total catecholamine levels and 24‐h ambulatory BP. Multivariate linear regression indicated that being male (β = 1.65, 95% confidence interval [CI] 0.01–3.29, p = .048) and 24‐h urine total catecholamine (β = 5.03, 95% CI 0.62–9.44, p = .025) were both independently associated with 24‐h SBP; being male was independently associated with 24‐h DBP (β = 3.55, 95% CI 2.26–4.85, p < .001). In conclusion, Chinese men with hypertension had higher SNS activity than women, and SNS activity was independently associated with 24‐h ambulatory BP in men rather than in women. These findings suggest that different hypertensive treatment strategies should be considered according to patient sex.

APOE Genetic Polymorphism rs7412 T/T Genotype May Be a Risk Factor for Essential Hypertension among Hakka People in Southern China

“…The APOE rs7412T/T genotype was found to be a risk factor for hypertension in this study. It has been reported that hypertensive patients have higher catecholamine levels [ 52 , 53 ]. The results of this study showed that APOE rs7412T/T subjects had higher catecholamine levels than C/C subjects, but there was no statistically significant difference.…”

“…e APOE rs7412T/T genotype was found to be a risk factor for hypertension in this study. It has been reported that hypertensive patients have higher catecholamine levels [52,53].…”

Triglyceride-Glucose Index for the Diagnosis of Metabolic Syndrome: A Cross-Sectional Study of 298,652 Individuals Receiving a Health Check-Up in China

“…Second, IR stimulates pro-opiomelanocortin (POMC)-releasing neurons in the arcuate nucleus of the hypothalamus, and activates glutamatergic neurons and neurons that express melanocortin 4 receptor (MC4R) in the paraventricular nucleus; thus enhancing the overall activity of the sympathetic nervous system [ 42 , 43 ]. The vasodilatory effect observed in hypertensive patients is thus impaired, with sympathetic nerve activation three times that in normal, unaffected individuals [ 44 ]. Lin et al uncovered IR as an alarming cause of impaired glucose metabolism and dyslipidemia in the body [ 45 ], and Feng indicated that IR was directly correlated with triglycerides and total cholesterol in Chinese patients [ 46 ].…”