Gender differences in the timing of arterial wave reflection beyond differences in body height

Objectives The timing of arterial wave reflection affects the shape of the arterial waveform and thus is a major determinant of pulse pressure. This s tudy assessed differences in wave reflection between genders beyond the eff ect of body height. Methods From 1123 elderly (aged 71 +/- 5 years) currently untreated hyperte nsives, we selected 104 pairs of men and women with identical body height ( average 164 +/- 4 cm). All subjects underwent echocardiography, including m easurement of aortic arch expansion, automated blood pressure measurements, measurement of ascending aortic blood flow and simultaneous carotid artery tonometry. Results Women had higher pulse (80 +/- 17 versus 74 +/- 17 mmHg, P < 0.05) and lower diastolic pressure (79 +/- 11 versus 82 +/- 10 mmHg, P < 0.05). W hilst heart rate was similar, women had a longer time to the systolic peak (210 +/- 28 versus 199 +/- 34 ms, P < 0.01) and a longer ejection time (304 +/- 21 versus 299 +/- 25 ms, P < 0.001). Wave reflection occurred earlier in women (time between maxima 116 +/- 55 versus 132 +/- 47 ms, P < 0.05) an d augmentation index was higher (36 +/- 11 versus 28 +/- 12%, P < 0.001). A ortic diameter was smaller in women and the aortic arch was stiffer (median E-p 386 versus 302 kN/m(2), P < 0.05). Hence, systemic arterial compliance was less in women (0.8 +/- 0.2 versus 1.0 +/- 0.3 ml/mmHg). Conclusions We conclude that elderly hypertensive men and women have a diff erent timing of both left ventricular ejection and arterial wave reflection when both genders are matched for body height Women have smaller and stiff er blood vessels resulting in an earlier return of the reflected wave, whic h is likely due to an increased pulse wave velocity in women. J Hypertens 1 9:2197-2203 (C) 2001 Lippincott Williams & Wilkins.