GENDER DIFFERENCES IN EARLY MANIFESTATIONS OF ARTERIAL STIFFNESS: RESULTS FROM THE SARDINIA PROJECT

Background Central arterial distensibility declines early in life, setting the stage for a dramatic increase in pulse pressure. However, the underlying alterations in maximal arterial expansion in systole and recoil in diastole, and gender differences in these alterations are not clear. Methods We analyzed longitudinal data of 3066 women and 2155 men (mean age 43 year, range 14-96) from the SardiNIA project. Brachial systolic (SBP) and diastolic (DBP) blood pressure were measured. B-mode ultrasound was used to measure common carotid systolic (SD) and diastolic (DD) diameters. Carotid strain (CS) was calculated as (SD -DD)/DD. Linear regression was used to assess changes in carotid parameters with aging adjusting for SBP and DBP. Results About 80% of the decline in CS occurred by the age of 50. (Fig1A). In men, this decline was due to a pronounced increase in DD (β=0.1, p<.0001) with no change in SD (Fig1B). Similarly, the decline in CS among women before the age of 30 was due to an increase in DD (β=0.03, p<.0001) with no change in SD; however, between the ages of 30 and 50, women had a decrease in SD (β=−0.03, p<.0001) with no change in DD (Fig1C). The smaller decline in CS after the age of 50 (Fig1A) reflected parallel increases in both SD and DD (Fig1B,C). Conclusion In both genders and adjusting for blood pressure, the early decline in CS was due to increasing DD and not decreasing SD suggesting initial impaired recoil rather than restricted expansion; however, the latter seems to subsequently develop in women.