Department of General Practice, Turku University and Turku University Hospital, Turku, Finland.
Central Satakunta Health Federation of Municipalities, Harjavalta, Finland.
J Hum Hypertens. 2021 Apr;35(4):371-377. doi: 10.1038/s41371-020-0339-z. Epub 2020 May 4.
Many unexplained sex differences have been observed in blood pressure (BP) related morbidity. However, there has been little research about the most obvious difference between men and women-body size. Given that blood vessels are organs of tubular shape, we hypothesized that correction of BP for body surface area (BSA), a two-dimensional measurement of body size, would allow comparison of BP load between men and women. We assessed the relationship of 24-h ambulatory BP measurements and BSA in 534 participants (mean age 61 ± 3 years, 51% women) from the Helsinki Birth Cohort Study. The study subjects had no previous medication affecting vasculature or BP. When BP values were adjusted for age, smoking, physical activity, and body fat percentage, males had higher ambulatory daytime mean systolic BP (131 mmHg vs. 127 mmHg, p < 0.001), diastolic BP (83 mmHg vs. 78 mmHg, p < 0.001), and mean arterial pressure (100 mmHg vs. 96 mmHg, p < 0.001) than females. However, all BP components per unit of BSA were significantly lower in males: daytime mean systolic BP (65 mmHg vs. 71 mmHg, p < 0.001), diastolic BP (41 mmHg vs. 44 mmHg, p < 0.001), pulse pressure (24 mmHg vs. 28 mmHg, p = 0.013), and mean arterial pressure (49 mmHg vs. 54 mmHg, p < 0.001). The same phenomenon was observed in night-time BP values. BP load per BSA is higher in women than in men, which may explain many reported sex differences in cardiovascular morbidity. Relatively small-sized individuals might benefit from a more aggressive therapeutic strategy.
许多与血压（BP）相关的发病率存在未被解释的性别差异。然而，关于男性和女性之间最明显的差异——体型，研究甚少。鉴于血管是管状器官，我们假设用体表面积（BSA）校正 BP，即身体大小的二维测量，将允许比较男女之间的 BP 负荷。我们评估了 534 名来自赫尔辛基出生队列研究的参与者（平均年龄 61±3 岁，51%为女性）的 24 小时动态血压测量和 BSA 的关系。研究对象没有以前影响血管或 BP 的药物治疗。当 BP 值根据年龄、吸烟、体力活动和体脂百分比进行调整时，男性的日间平均收缩压（131mmHg 与 127mmHg，p<0.001）、舒张压（83mmHg 与 78mmHg，p<0.001）和平均动脉压（100mmHg 与 96mmHg，p<0.001）均高于女性。然而，男性的所有 BP 成分每单位 BSA 都显著降低：日间平均收缩压（65mmHg 与 71mmHg，p<0.001）、舒张压（41mmHg 与 44mmHg，p<0.001）、脉压（24mmHg 与 28mmHg，p=0.013）和平均动脉压（49mmHg 与 54mmHg，p<0.001）。夜间 BP 值也观察到了同样的现象。每单位 BSA 的 BP 负荷在女性中高于男性，这可能解释了许多已报道的心血管发病率中的性别差异。相对较小体型的个体可能受益于更积极的治疗策略。
