Sex, gender, and subclinical hypertensiveorgan damage—heart

Cuspidi, Cesare; Gherbesi, Elisa; Sala, Carla; Tadić, Marijana

doi:10.1038/s41371-022-00750-5

Cited by 8 publications

(5 citation statements)

References 83 publications

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“…Whether the prevalence of LVH is higher in women than in men is debatable [32][33][34][35]. However, it is widely acknowledged that the prevalence of LVH is higher in postmenopausal women than in men [32], which may be related to higher serum testosterone levels [36,37].…”

Section: Discussionmentioning

confidence: 99%

Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

Tan,

Wang,

Sun

et al. 2024

J Intern Med

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BackgroundLeft ventricular hypertrophy (LVH) is highly prevalent in haemodialysis (HD) patients and is associated with an increased risk of death. Roxadustat and recombinant human erythropoietin (rHuEPO, abbreviated as EPO) are the main treatment strategies for renal anaemia in HD patients, but it has not been clear whether there is a difference in their effect on LVH.MethodsIn this multi‐centre, prospective, randomized trial of 12‐month duration, study participants were randomized in a 1:1 ratio to the roxadustat group or the EPO group. The doses of both treatment regimens were adjusted so that the patients had a haemoglobin level of 10.0–12.0 g per dL. The primary study endpoint was the change from baseline to 12 months in the left ventricular mass index (LVMI, g/m2) measured by echocardiography.ResultsIn total, 114 patients were enrolled. The mean age was 50 years, and the median dialysis duration was 33 months. Sixty‐one patients were men, and 24 were diabetic. LVMI decreased from 116.18 ± 27.84 to 110.70 ± 25.74 g/m2 in the roxadustat group. However, it increased from 109.35 ± 23.41 to 114.99 ± 28.46 g/m2 in the EPO group, with a significant difference in the change in LVMI between the two groups [−5.48 (−11.60 to 0.65) vs. 5.65 (0.74 to 10.55), p < 0.05]. Changes in left ventricular mass, end‐diastolic volume and 6‐min walk test seemed superior in the roxadustat group. There were no significant differences in other cardiac geometry, biochemical parameters and major adverse cardiovascular events between the two groups.ConclusionsCompared to EPO, roxadustat is more helpful in the regression of LVH in HD patients.

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Section: Discussionmentioning

confidence: 99%

Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

Tan,

Wang,

Sun

et al. 2024

J Intern Med

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“…A mounting body of evidence suggests that hypertensive women are more likely to develop LV remodelling and are less sensitive to the favourable effects of BP lowering-drugs on LVH regression, disproving the traditional paradigm that men are at higher risk of developing organ damage than women [20,35,36]. It has been suggested that sex hormones play a key role in determining gender differences in the cascade of events leading to the development of target organ damage.…”

Section: Discussionmentioning

confidence: 99%

“…In view of the growing evidence suggesting that women are more likely to develop LVH than men in front of similar exposure to cardiovascular risk factors we hypothesized that hyperuricemia may have a different impact on the development of LVH between sexes [18][19][20]. Thus, we performed a meta-analysis of echocardiographic studies providing data on the relationship between SUA and LV mass (LVM) through a gender-based analysis.…”

Section: Introductionmentioning

confidence: 99%

Uric acid and left ventricular hypertrophy: a gender-based meta-analysis of echocardiographic studies

Gherbesi,

Faggiano,

Sala

et al. 2023

Journal of Hypertension

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Aim: Gender-based evidence on the association between serum uric acid (SUA) and left ventricular hypertrophy (LVH), as assessed by echocardiography, is still based on single studies. Thus, we performed a systematic meta-analysis of echocardiographic studies in order to provide an updated and comprehensive information on this issue. Methods: The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English-language articles published from the inception up to March 31, 2023. Studies were identified by using MeSH terms and crossing the following search items: ‘uric acid’, ‘hyperuricemia’, ‘left ventricular mass’, ‘left ventricular hypertrophy’, ‘echocardiography’, ‘female’, ‘male’. Results: Six studies including 2791 normotensive and hypertensive individuals were considered for the analysis. In women, increasing values of SUA were associated with progressively higher values of age, body mass index (BMI) and systolic blood pressure (SBP). This was not the case for men. In women, the meta-analysis comparing LV mass index (LVMI) in low versus high SUA group showed a greater pooled LVMI in the high SUA group [standard means difference (SMD): 0.81 ± 0. 24, confidence interval (CI) 0.34–1.27, P < 0.0001]. On the contrary, in men no statistical difference was found between the low group and high SUA group (SMD: 0.27 ± 0.27, CI: −0.27/0.81, P = 0.32). Conclusions: Our meta-analysis suggests that hyperuricemia portends the likely presence of increased LVMI in women but not in men. However, as hyperuricemia in the female pooled population, different from men, was associated with older age, higher BMI and SBP, the present findings do not support an independent role of the SUA in LV remodelling process in women.

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“…Hoshida et al [33] have shown a more pronounced increase in LVH and myocardial stiffness in older female patients with hypertension than male patients. One possible explanation for this finding is that estrogen regulates the activity of the renin-angiotensin-aldosterone system (RAAS), the sympathetic nervous system, and oxidative stress, all of which are key factors in the development of structural abnormalities in the heart [34]. Additionally, postmenopausal women tend to have higher levels of inflammatory factors, such as TNF α, interleukin, and plasma protein activator inhibitor-1, as well as the fibrosis marker galectin-3, than men [35].…”

Section: Discussionmentioning

confidence: 99%

Correlation between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and Left Ventricular Hypertrophy in Older Patients with Hypertension*

Liu,

Wang,

Meng

et al. 2023

CVIA

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Introduction: Hypertension and left ventricular hypertrophy (LVH) have emerged as significant risk factors for cardiovascular events and all-cause mortality. Inflammation and nutrition play critical roles in the development of hypertension and damage to target organs. The HALP Score, which assesses levels of hemoglobin, albumin, lymphocytes, and platelets, is an index closely associated with inflammation and nutrition, and has been demonstrated to be particularly effective in the older population. Hence, the objective of this study was to examine the correlation between the HALP Score and LVH in older patients with hypertension. Methods: We collected and retrospectively analyzed data from 234 older patients, including clinical data, and routine blood, liver function, kidney function, and cardiac ultrasound parameters. All patients were categorized into a non-left ventricular hypertrophy (NLVH) group (n = 131) or an LVH group (n = 103). The association between the HALP Score and LVH was investigated, and potential influencing factors were considered. Results: The LVH group had a significantly lower HALP Score than the NLVH group. Logistic regression analysis revealed that a lower HALP Score and female sex were independent factors associated with LVH in older patients with hypertension (OR = 0.944, 9.962, 95% CI: 0.910–0.979, 3.866–24.300, P = 0.002, <0.001). The area under the curve for the HALP Score in diagnosing LVH in older patients with hypertension was 0.708 (95% CI: 0.641–0.776, P = 0.002). Conclusion: The HALP Score is significantly associated with LVH in older patients with hypertension: lower scores indicate a greater likelihood of LVH. The HALP Score has moderate diagnostic value for LVH in this population.

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Sex, gender, and subclinical hypertensiveorgan damage—heart

Cited by 8 publications

References 83 publications

Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

Uric acid and left ventricular hypertrophy: a gender-based meta-analysis of echocardiographic studies

Correlation between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and Left Ventricular Hypertrophy in Older Patients with Hypertension*

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