Sex differences in diastolic blood pressure changes with age using 24-hour ABPM in 30,513 patients
Autor: | M Cases, Murray F. Matangi, D Armstrong, T Zhu, D. Brouillard |
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Rok vydání: | 2020 |
Předmět: | |
Zdroj: | European Heart Journal. 41 |
ISSN: | 1522-9645 0195-668X |
DOI: | 10.1093/ehjci/ehaa946.3166 |
Popis: | Background We have previously shown, using 24-hour ABPM monitoring, that diastolic blood pressure (DBP) in a large referral population, containing both males and females, increases until age 42 years, following which DBP falls progressively. This occurs in the hypertensive population some 13 years sooner than previous general population studies. There is conflicting emerging data on sex differences in the lifelong trajectory of both systolic and diastolic blood pressure. Purpose To examine sex-specific patterns of diastolic blood pressure throughout the lifespan of patients referred for 24-hour ABPMs. Methods Our database was searched for all 24-hour ABPMs. We used the average 24-hour SBP and DBP for this analysis. Scatter grams were produced for age versus systolic BP (SBP) and DBP for both males and females. Second order polynomial regression was performed on the DBP scatter grams for both genders and their inflection points calculated. The inflection point is the age at which the DBP on the polynomial curve where the slope changes from positive to negative. This, inflection point, corresponds to the age at which DBP begins to decrease. The DBP polynomial curves for males and females were then superimposed to show any gender differences. Results There were 30,513 24-hour analysable ABPMs over 24 years, representing 97% of all ABPMs. There were 15,913 females aged 60.8±14.6 years (range 15–97 years) and 14,600 males aged 58.8±14.2 years (range 15–100 years). As can be seen from the charts below, in females DBP begins to fall at a very early age of 22.3 years, whereas in males the diastolic BP begins to fall at 46.5 years. Conclusions There are significant sex differences in the changes in DBP with increasing age. For the first 35 years DBP is higher in women, thereafter DBP is lower in females and only intersects again much later in life at 95 years. The significance of this sex difference is unclear but may explain the increased prevalence of systolic hypertension in elderly females. Figure 1 Funding Acknowledgement Type of funding source: None |
Databáze: | OpenAIRE |
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