Sex Differences in Association of Elevated Blood Pressure with Variables Characterizing Cardiometabolic Risk in Young Subjects with or Without Metabolic Abnormalities

Abstract

Males present higher blood pressure (BP) values, higher prevalence of elevated BP, and a different prevalence of cardiometabolic risk factors when compared with females. We assumed that the trends of risk markers across BP categories (normotension, high normal BP, and hypertension) differ in young males and females, and between subjects without metabolic abnormalities (without obesity, insulin resistance, atherogenic dyslipidemia, hyperuricemia, or microinflammation) and those presenting them. Data from 2543 subjects (48% males) aged from 16 to 23 years were analyzed. The findings showed that 15% of males and 4% of females presented high normal BP while 9% and 1%, respectively, had hypertension. In males, variables characterizing obesity status, insulin sensitivity, atherogenic dyslipidemia, uric acid, adiponectin, a soluble receptor for advanced glycation end-products, and leukocyte counts showed worsening trends across BP categories. Females presented significant trends only for obesity measures, LDL-cholesterol, and non-HDL-cholesterol. Across BP categories, trends of variables characterizing cardiometabolic risk differed among abnormalities-free and presenting males. The multivariate model selected measures of central obesity, atherogenic dyslipidemia, insulin resistance, and uric acid as significant predictors of BP in both genders, and C-reactive protein in females. Sex differences in measures of cardiovascular health in juveniles may remain undiscovered unless two sexes are analyzed separately. These differences may have implications for sex-specific disease risk in adulthood.

Prevalence of arterial hypertension among Ukrainian students: the comparison of European and American guidelines

“…Children with excessive weight had abnormal BP and HTN significantly more often than proportional ones [3,5,6,22,23,30], but we did not identify statistically better sensitivity of AAP criteria by reclassification, which may be due to an insufficient number of identified patients. However, an Italian study with analysed a sample 2929 overweight/obese young people (6-16 years old) identified that children considered non-hypertensive by ESH 327 (11%) were reclassified using the lower cut-off point suggested by the AAP [7].…”

“…We confirmed that boys are generally 3 times more predisposed to abnormal BP, which is close to the results of other studies [ 15 , 18 , 20 ]. Sebekova et al ., based on survey data from 2543 Slovak students of secondary schools aged from 16 to 23 years, showed that 15% of males and 4% of females presented high normal BP whilst 9% and 1%, respectively, had hypertension [ 22 ]. However, a meta-analysis of global trends recognized no statistically significant difference in prevalence rates between sexes [ 2 ].…”

Could AGEs be markers of pre-eclampsia? Study of concentration of advanced protein glycation products in pregnant women with physiological pregnancy and pregnancy complicated with pre-eclampsia

“…Many risk factors for PE have been identified, but the exact etiology of this disorder has not been explained yet [15]. Considering the above, the role of the cell surface pattern recognition receptor for advanced glycation end products (RAGE) seems to be of significant importance in the etiology of PE [16].…”