INFLUENCE OF GENDER ON THE LEVEL OF PULSE PRESSURE - THE ROLE OF LARGE CONDUIT ARTERIES

The blood pressure curve may be divided into two components: a steady component represented by the mean arterial pressure, and a pulsatile c omponent represented by the pulse pressure. Whether the contribution o f either these two components may be different in men and women was no t yet investigated. The present study used 24 hours ambulatory brachia l blood pressure monitoring and determination of casual carotid and ra dial pulse pressure by applanation tonometry to investigate 320 subjec ts (199 men and 121 women) with normal or elevated blood pressure. Wit h ambulatory blood pressure monitoring, there was no gender influence on the mean values of mean and diastolic blood pressure, but men were characterized by a significantly higher systolic and pulse pressure (P <0.001). In women, pulse pressure was strongly and positively correlat ed with systolic (and not diastolic) blood pressure. In men, pulse pre ssure was positively correlated with systolic blood pressure and negat ively with diastolic blood pressure (P<0.001). In the overall populati on (men plus women), brachial ambulatory pulse pressure was positively correlated with body height and mean arterial pressure (P<0.001) but the latter correlation was stronger in women. Applanation tonometry in dicated that, whereas carotid pulse pressure was identical In men and women, men had a significantly higher radial systolic blood pressure, indicating a gender difference in pressure wave transmission. The stud y provides evidence that men and women did not differ in terms of mean arterial pressure, but rather in terms of pulse pressure and pressure wave transmission, indicating that large (and not only small) arterie s modulate the gender difference In the level of blood pressure. This finding may have important implications for the diagnosis and the clin ical management of subjects with hypertension.