Key result
Higher female BMI linked to increased arterial stiffness, an effect not observed in males.
Why the study?
Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity, prompting evaluation of gender-based effects on arterial stiffening in obesity.
Is female sex associated with a higher susceptibility to weight-induced arterial stiffening and blood pressure elevation?
Cross-Sectional (n=834)
No
Is female sex associated with a higher susceptibility to weight-induced arterial stiffening and blood pressure elevation?
Effect estimate: β = 0.06 (95% CI 0.01 to 0.1)
p-value: p=< 0.05
Female sex may confer a disproportionately higher susceptibility to weight-induced arterial stiffening and subsequent central blood pressure elevation compared to males.
Female sex may heighten obesity-related arterial stiffening risk; leaves open causality and need for prospective validation before clinical adoption.
Arterial stiffness is an important predictor of cardiovascular events, independent of traditional risk factors. Stiffening of arteries, though an adaptive process to hemodynamic load, results in substantial increase in the pulsatile hemodynamic forces that detrimentally affects the microcirculation perfusing the vital organs such as the brain, heart and kidneys. Studies have proposed that arterial stiffness precedes and may contribute to the development of hypertension in individuals with obesity. Our study sought to determine the gender-based effects on arterial stiffening in obesity which may predispose to the development of hypertension. We found female sex is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure in obesity. Women had significantly higher carotid-femoral pulse wave velocity (CF-PWV) with higher body mass index (BMI) status (normal: 7.9 ± 2 m/s; overweight: 9.1 ± 2 m/s; obese: 9 ± 2 m/s, p < 0.001), whereas it was similar in males across all BMI categories. The linear association between arterial stiffness and BMI following adjustment for age and brachial systolic and diastolic blood pressure (BP), remained significant in females (β = 0.06; 95% CI 0.01 to 0.1; p < 0.05) but not in males (β = 0.04; 95% CI −0.01 to 0.1; p > 0.05). The mean CF-PWV values increased by 0.1 m/s for every 1 kg/m2 increase in BMI in the female subjects in the age adjusted linear model, while such effect was not seen in the male subjects. In line with arterial stiffening, the overweight and obese females demonstrated significantly higher systolic brachial BP. (BP difference: ΔBP 9−11 mmHg, p < 0.01) and central systolic pressure (ΔBP 8−10 mmHg, p < 0.05) compared to their lean counterparts, unlike the male subjects. Our results suggest that female gender is associated with higher susceptibility of weight-related arterial stiffening and rise in blood pressure.
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Zuo et al. (2021) conducted a cross-sectional in Cardiovascular risk screening (n=834). Higher body mass index (BMI) vs. Normal BMI / Male subjects was evaluated on Linear association between arterial stiffness (CF-PWV) and BMI (β = 0.06, 95% CI 0.01 to 0.1, p=< 0.05). Higher body mass index in females was significantly associated with increased arterial stiffness (CF-PWV increased by 0.1 m/s per 1 kg/m2 increase in BMI) and elevated systolic blood pressure, an effect not observed in males.
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