Alfie J, Waisman G D, Galarza C R, Magi M I, Vasvari F, Mayorga L M, Cámera M I
Unidad de Hipertension Arterial, Servicio de Clinica Medica, Hospital Italiano, Buenos Aires, Argentina.
Hypertension. 1995 Dec;26(6 Pt 2):1195-9. doi: 10.1161/01.hyp.26.6.1195.
Sex-related differences in systemic hemodynamics were analyzed by means of cardiac index and systemic vascular resistance according to the level of daytime ambulatory blood pressure. In addition, we assessed the relations between ambulatory blood pressure measurements and systemic hemodynamics in male and female patients. We prospectively included 52 women and 53 men referred to our unit for evaluation of arterial hypertension. Women and men were grouped according to the level of daytime mean arterial pressure: < 110 or > or = 110 mm Hg. Patients underwent noninvasive evaluation of resting hemodynamics (impedance cardiography) and 24-hour ambulatory blood pressure monitoring. Compared with women men with lower daytime blood pressure had a 12% higher systemic vascular resistance index (P = NS) and a 14% lower cardiac index (P < .02), whereas men with higher daytime blood pressure had a 25% higher vascular resistance (P < .003) and a 21% lower cardiac index (P < .0004). Furthermore, in men systemic vascular resistance correlated positively with both daytime and nighttime systolic and diastolic blood pressures, whereas cardiac index correlated negatively only with daytime diastolic blood pressure. In contrast, women did not exhibit any significant correlation between hemodynamic parameters and ambulatory blood pressure measurements. In conclusion, sex-related differences in systemic hemodynamics were more pronounced in the group with higher daytime hypertension. The relations between systemic hemodynamics and ambulatory blood pressure level depended on the sex of the patient. In men a progressive circulatory impairment underlies the increasing level of ambulatory blood pressure, but this was not observed in women.
根据日间动态血压水平，通过心脏指数和全身血管阻力分析全身血流动力学的性别差异。此外，我们评估了男性和女性患者动态血压测量值与全身血流动力学之间的关系。我们前瞻性纳入了52名女性和53名男性，他们因动脉高血压转诊至我院进行评估。根据日间平均动脉压水平将女性和男性分组：<110或≥110 mmHg。患者接受静息血流动力学的无创评估（阻抗心动图）和24小时动态血压监测。与女性相比，日间血压较低的男性全身血管阻力指数高12%（P=无显著性差异），心脏指数低14%（P<0.02），而日间血压较高的男性血管阻力高25%（P<0.003），心脏指数低21%（P<0.0004）。此外，在男性中，全身血管阻力与日间和夜间收缩压及舒张压均呈正相关，而心脏指数仅与日间舒张压呈负相关。相比之下，女性血流动力学参数与动态血压测量值之间未表现出任何显著相关性。总之，全身血流动力学的性别差异在日间高血压较高的组中更为明显。全身血流动力学与动态血压水平之间的关系取决于患者的性别。在男性中，动态血压水平升高的基础是进行性循环功能障碍，但在女性中未观察到这种情况。
