Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Sex differences in cardiac adaptation to essential hypertension
Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation New Orleans, Louisiana
Received 1 November 1988; revised 18 May 1989; .
Correspondence: Dr F. H. Messerli, Ochsner Clinic, 1514 Jefferson Highway, New Orleans, Louisiana 70121, USA
Abstract
Left ventricular functional and structural adaptations to mild essential hypertension were assessed by 2D-guided M-mode echocardiography in a population of premenopausal and postmenopausal women (n=29) who were matched with the same number of men with regard to mean arterial pressure, age and race. Premenopausal women had a thinner posterial wall (P<0.05), a smaller left ventricular systolic and diastolic diameter, and a smaller left ventricular mass than men with the same level of arterial pressure. Left ventricular performance indices, ejection fraction, velocity of circumferential fibre shortening, and the ratio of the end-systolic wall stress to the end-systolic volume index (a load-insensitive contractility index) were higher in women than in men. These sex differences were most pronounced before the menopause and tended to disappear thereafter. We conclude that in the presence of the same level of arterial pressure, women have smaller left ventricular dimensions and enhanced ventricular performance compared with men. These differences in cardiac adaptations between the genders may account for the lower risk of cardiovascular mobidity and mortality in premenopausal women with essential hypertension.
Key Words: Left ventricular hypertrophy • hypertension • haemodynamics • congestive heart failure
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