Bos Elke M E, Tol Johan T M, de Boer Fabienne C, Schenk Jimmy, Hermanns Henning, Eberl Susanne, Veelo Denise P
Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
J Clin Med. 2024 Jan 24;13(3):666. doi: 10.3390/jcm13030666.
: Major determinants of blood pressure (BP) include sex and age. In youth, females have lower BP than males, yet in advanced age, more pronounced BP increases result in higher average BPs in females over 65. This hypothesis-generating study explored whether age-related BP divergence impacts the incidence of sex-specific intraoperative hypotension (IOH) or hypertension. We systematically searched PubMed and Embase databases for studies reporting intraoperative BP in males and females in non-cardiac surgery. We analyzed between-sex differences in the incidence of IOH and intraoperative hypertension (primary endpoint). : Among 793 identified studies, 14 were included in this meta-analysis, comprising 1,110,636 patients (56% female). While sex was not associated with IOH overall (females: OR 1.10, 95%CI [0.98-1.23], = 99%), a subset of studies with an average age ≥65 years showed increased exposure to IOH in females (OR 1.17, 95%CI [1.01-1.35], = 94%). One study reported sex-specific differences in intraoperative hypertension, with a higher incidence in females (31% vs. 28%). : While sex-specific reporting on intraoperative BP was limited, IOH did not differ between sexes. However, an exploratory subgroup analysis offers the hypothesis that females of advanced age may face an increased risk of IOH, warranting further investigation.
血压（BP）的主要决定因素包括性别和年龄。在青年时期，女性的血压低于男性，但在老年时，血压更显著的升高导致65岁以上女性的平均血压更高。这项产生假设的研究探讨了与年龄相关的血压差异是否会影响特定性别的术中低血压（IOH）或高血压的发生率。我们系统地检索了PubMed和Embase数据库，以查找报告非心脏手术中男性和女性术中血压的研究。我们分析了IOH发生率和术中高血压（主要终点）的性别差异。在793项已确定的研究中，有14项纳入了这项荟萃分析，包括1,110,636名患者（56%为女性）。虽然总体而言性别与IOH无关（女性：OR 1.10，95%CI [0.98 - 1.23]，P = 99%），但平均年龄≥65岁的一组研究显示女性发生IOH的风险增加（OR 1.17，95%CI [1.01 - 1.35]，P = 94%）。一项研究报告了术中高血压的性别差异，女性的发生率更高（31%对28%）。虽然关于术中血压的性别特异性报告有限，但IOH在性别之间没有差异。然而，一项探索性亚组分析提出了一个假设，即老年女性可能面临更高的IOH风险，值得进一步研究。
