Stronger Association Between Blood Pressure and Arterial Stiffness in Older Women than Men: The Hordaland Health Study.

INTRODUCTION

Sex differences in the life course development of brachial blood pressure (Bi et al. N Engl J Med, 2024. https://doi.org/10.1056/NEJMoa2412006 ) and the association between brachial and central BP are well documented.

AIM

To explore if the associations of brachial and central BP with the presence of increased arterial stiffness differ between older women and men.

METHODS

Data from 1135 women and 943 men aged 68 in the Hordaland Health Study were used. Brachial BP was categorised as normal (BP< 130/85 mmHg), high-normal (BP 130-139/85-89 mmHg) or hypertension (BP≥140/90 mmHg). Arterial stiffness was assessed from carotid-femoral pulse wave velocity (cfPWV), and central systolic BP from brachial pulse wave analysis. Sex-specific associations between BP and increased arterial stiffness (cfPWV >10 m/s) were tested in logistic regression analyses and reported as odds ratio (OR) and 95% confidence intervals (CI).

RESULTS

In multivariable analyses, both hypertension and high-normal BP were more strongly associated with presence of increased arterial stiffness in women (OR 5.81 [95% CI 3.86-8.75] and OR 2.56 [95% CI 1.43-4.56], respectively) compared to men (OR 2.56 [95% CI 1.43-4.56] and OR 2.01 [95% CI 1.22-3.33], both p for sex-interaction <0.05). Additionally, central systolic BP showed a stronger association with increased arterial stiffness in women (OR 1.06 [95% CI 1.05-1.07]) than in men (OR 1.05 [95% CI 1.04-1.06], p for sex-interaction <0.05).

CONCLUSIONS

In 68-year-old individuals, a high normal BP, hypertension and higher central systolic BP were all more strongly associated with the presence of increased arterial stiffness in women than in men.