Are There Sex Differences in BP Trajectories Throughout the Lifespan?
BACKGROUND AND PURPOSE:
Women often experience cardiovascular disease (CVD) onset about 10 to 20 years after the average onset of CVD in men
Increasing evidence suggests that cardiovascular physiology differ between men and women
Ji et al. (JAMA Network Open, 2020) evaluated whether longitudinal patterns of blood pressure (BP) elevation differ between women and men throughout the lifespan
Analyses of longitudinal data from 4 US cohort studies (1971 to 2014)
Data derived from National Heart, Lung, and Blood Institute BioLINCC repository
Ages 5 to 98 years with serial BP measures
BP measures: Systolic BP | Diastolic BP | Mean arterial pressure (MAP) | Pulse pressure (PP)
Mixed-effects regression models were used to display BP trajectories in women and men separately
Age used as the common timescale for all analyses
Sex-specific change in BP measures compared with baseline BP levels
Compared to men, women had a steeper increased in all BP trajectories (P <0.001)
After adjustment for multiple cardiovascular disease risk factors, these between-sex differences in all BP trajectories persisted (P for all <0.001)
The steeper risk begins as the third decade and continued throughout life
Similar trends observed when data stratified by
Race/ethnicity | Cohort | Antihypertensive medication use
Incidence of new-onset CVD events were higher in men than in women over the adult life course
Hazard ratio1.61 (95% CI, 1.54-1.69); P < .001
When analyzed by sex, measures of BP actually progresses more rapidly in women than they do in men, and this progression starts early in life
The authors suggest that rather than women lagging behind men in CVD processes, women experience early-onset cardiovascular progression that sets the stage for CVD in later life
The authors state that CVD in women presents differently, not just later
In contrast with the notion that important vascular diseases in women lag behind men by 10 to 20 years, our findings indicate that certain vascular changes not only develop earlier but also progress faster in women than in men
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