Gender Difference in Blood Pressure Regulation in Essential Hypertension

• Published in: Hypertension Research Vol. 17; no. 1; pp. 71 - 78
• Main Authors: Muneta, Shinjiro, Murakami, Eiki, Hiwada, Kunio
• Format: Journal Article
• Language: English
• Published: The Japanese Society of Hypertension 1994
• Subjects: baroreceptor reflex; essential hypertension; gender difference; isometric handgrip exercise; mental arithmetic test; pituitary gonadotropin; pulse wave velocity
• DOI: 10.1291/hypres.17.71
• EISSN: 1348-4214
• ISSN: 0916-9636

To investigate the gender difference in the pathophysiology of essential hypertension, we investigated baroreflex sensitivity (BRS), aortic pulse wave velocity (PWV), blood pressure responses to mental arithmetic tests (MAT) and isometric handgrip exercise (IHG) in normotensive subjects (NT) and essential hypertensive patients (EHT) of both genders. EHT were classified as stage I (EHT-I) or stage II (EHT- II) according to the WHO stage classification. BRS in males tended to decline with increasing age and showed a significant (p<0.01) inverse correlation with PWV. Male EHT-II showed a significantly lower BRS than NT and EHT-I, and BRS in EHT-I was similar to that in NT. On the other hand, BRS in females decreased with age, reached a nadir around the first half of the fifth decade of life and tended to increase afterwards. Female EHT-I showed a substantially reduced value for BRS compared with NT, and BRS in EHT-II was similar to that in EHT-I. BRS in female EHT showed a significant (p<0.01) inverse correlation with serum gonadotropin level. Blood pressure response to MAT and clinic blood pressure were closely related to BRS in female subjects. We showed that male BRS declined gradually with aging and the progress of hypertension, while BRS in female EHT was substantially reduced even in the early stage of hypertension. The activation of the sex center regulating gonadotropin secretion may be one of the causative factors of the baroreflex impairment in females. These findings suggest that ovarian dysfunction is an another important factor influencing the baroreflex function in addition to aging and blood pressure, and that the baroreflex impairment in females characterizes the gender difference in the pathophysiology of essential hypertension. (Hypertens Res 1994; 17: 71-78)