Important differences between hypertensive middle-aged women and men in cardiovascular autonomic control-a critical appraisal

Author(s)

Philbois, Stella V. ^[1] ; Facioli, Tabata P. ^[1] ; Gastaldi, Ada C. ^[1] ; Rodrigues, Jhennyfer A. L. ^[1] ; Tank, Jens ^[2] ; Fares, Thauane H. ^[1] ; Rodrigues, Karine P. ^[1] ; Souza, Hugo C. D. ^[1]

Affiliation

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Hlth Sci, Lab Exercise Physiol & Cardiovasc Physiotherapy, Av Bandeirantes 3900, Vila Monte Alegre, BR-14049900 Ribeirao Preto, SP - Brazil

^[2] German Aerosp Ctr, Inst Aerosp Med, Cologne - Germany

• Document type: Journal article
• Source: BIOLOGY OF SEX DIFFERENCES; v. 12, n. 1 DEC 11 2021.
• Web of Science Citations: 0

Abstract

Background: Normotensive premenopausal women show a vagal predominance of cardiac autonomic modulation, whereas age-matched men show a predominance of sympathetic modulation. However, some women develop systemic arterial hypertension (SAH) even with preserved ovarian function. Our hypothesis is that these women may have cardiovascular autonomic parameters similar to those of hypertensive men, even when subjected to pharmacological treatment. We aimed to investigate cardiovascular autonomic control and baroreflex sensitivity (BRS) in hypertensive premenopausal women and age-matched men. Methods: One hundred volunteers between 18 and 45 years of age were assigned to two groups (50 participants each): a hypertensive group including patients with a history of SAH for at least 6 months (25 men and 25 women), who were under treatment with monotherapy (losartan, 25-50 mg/kg); and a normotensive group (25 men and 25 women). Anthropometric, hemodynamic, metabolic, and autonomic cardiovascular assessments were performed focusing on BRS, autonomic modulation of heart rate variability (HRV), and blood pressure variability (BPV). Results: On HRV analysis, women showed higher values of high-frequency (HF) oscillations in absolute and normalized units, lower values of low-frequency (LF) in normalized units, and lower LF/HF ratio, as compared with men. When the normotensive and hypertensive groups were compared, hypertensive groups showed lower values of total variance and of LF and HF bands in absolute units. On BRS, hypertensive groups showed lower values than the normotensive group. Conclusion: Regardless of blood pressure control through pharmacological treatment, hypertensive patients continued to have reduced HRV compared to normotensive, and hypertensive men had more autonomic impairment than hypertensive premenopausal women. (AU)

• FAPESP's process: 18/17892-5 - Study of cardiovascular parameters in hypertensive women, before and after the menopause - effects of the association of aerobic physical training with enalapril maleate and losartan
• Grantee: Stella Vieira Philbois Duarte
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 18/08569-6 - Study of aerobic physical training association with enalapril maleate and losartan on different cardiovascular parameters in hypertensive women, before and after the menopause
• Grantee: Hugo Celso Dutra de Souza
• Support Opportunities: Regular Research Grants