High blood pressure reasons differ by gender in teens; young adults

September 15, 2017

SAN FRANCISCO, Sept. 15, 2017 - There are marked gender differences in what drives blood pressure in middle-age in adulthood, suggesting the need for gender-specific treatments for high blood pressure, according to research presented today at the American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017, in San Francisco.

Background

"Blood pressure is determined mainly by three factors: heart rate; stroke volume, which is the volume of blood pumped by the heart; and the resistance to blood flow through the vessels, called total peripheral resistance. An increase in any one of the three factors can lead to an increase in blood pressure," said study author Catriona Syme, Ph.D., postdoctoral fellow at The Hospital for Sick Children (SickKids) in Toronto, Ontario, Canada. "The key takeaway from this study is that, for young and middle-aged women, stroke volume was the main determinant of blood pressure, while, in men, vascular resistance was the main determinant of blood pressure."

Syme and colleagues studied 1,347 Canadians from the Saguenay Youth Study, including 911 adolescents and 426 adults ages 36 to 65 years. The researchers used a device that measures beat-by-beat blood pressure and the underlying forces of heart rate, stroke volume and total peripheral resistance. In the approximately hour-long protocol, they measured these variables at rest, and during posture changes and a mental stressor - all designed to mimic daily life activities, according to Syme.

Researchers found: This study is novel in that it looks at the relative contributions of the three parameters determining blood pressure, which have not been evaluated in a large population-based study, and it assesses these factors over time, in a way that mimics daily life activities. The study also looks at high blood pressure culprits in adolescents and young to middle aged adults, who are not frequently studied despite being affected by hypertension, according to Syme.

"For example, there have been many studies looking at sex differences in the usefulness of blood pressure medications. But, most of those studies have been done in people whose average age was 60-70 years -- many of the women being post-menopausal," Syme said. "We think pre-menopausal women and men of a similar age may have elevated blood pressure for different reasons, and thus may need to be treated for hypertension differently. After menopause, when the production of female sex hormones decreases, reasons for hypertension may be more similar in men and women."

While current treatment recommendations for hypertension do not differ by gender across all ages, this study suggests potential benefits to prescribing blood pressure-lowering medications with consideration for gender differences in the underlying physiology of elevated blood pressure in young and middle-aged adults.

This study was conducted in Caucasians. Future studies should investigate whether the relative contributions of these parameters differ by race.
-end-
Co-authors are Jean Shin, Ph.D.; Michal Abrahamowicz, Ph.D.; Gabriel Leonard, Ph.D.; Michel Perron, Ph.D.; Louis Richer, Ph.D.; Suzanne Veillette, Ph.D.; Daniel Gaudet, Ph.D.; and Tomas Paus, M.D., Ph.D.; the corresponding author is Zdenka Pausova, M.D. Author disclosures are on the manuscript.

The study was funded by the Canadian Institutes of Health Research, Canadian Foundation for Innovation and by the Heart and Stroke Foundation of Canada.

Note: Actual time of scientific presentation of abstract 44 is 3:45 p.m. PT/ 6:45 p.m. ET Friday, Sept. 15, 2017.

Additional Resources: Statements and conclusions of study authors that are presented at American Heart Association and American Stroke Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at http://www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke - the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

American Heart Association

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