Arterial Stiffness and Left Ventricular Diastolic Function

D iastolic heart failure with preserved systolic ejection fraction is becoming a major health burden and is responsible for Ͼ50% of heart failure hospital admissions. 1 Arterial hypertension is one of the most important risk factors for diastolic dysfunction; however, systolic and diastolic blood pressures are the 2 extreme points of the arterial waveform.Arterial stiffness/elasticity derived from the continuous arterial waveform has been the focus of research to expand knowledge of blood pressure with diastolic (dys)function. 2 Interestingly, women have a lower arterial elasticity (higher arterial stiffness) than men and tend to develop more diastolic dysfunction than men. 3 A consistent finding among population studies is that women significantly outweigh men in this disease in a range of 2:1.In this issue, Russo and coworkers reported their results about sex differences in relationship among arterial stiffness, wave reflections, and left ventricular diastolic function beyond the classical cardiovascular risk factors in the Cardiovascular Abnormalities and Brain Lesions (CABL) study cohort.4 They used applanation tonometry, considering the following hemodynamic parameters: central pulse pressure/stroke volume index, total arterial compliance, pulse pressure amplification, and augmentation index.These parameters of arterial stiffness and wave reflection were greater in women compared with men, independent of body size and heart rate, and showed inverse relationships with parameters of diastolic function in both sexes.Further adjustment for cardiovascular risk factors attenuated these relationships; however, the ratio central pulse pressure/stroke volume predicted left ventricular dysfunction both in women and men, independent of other risk factors.This study had several limitations.This was a cross-sectional design and did not allow demonstration of a cause-effect relationship.The majority of the central hemodynamic parameters provide only indirect information about arterial stiffness.Carotid-femoral pulse wave velocity, which is an important parameter for aortic stiffness, was not measured.Antihypertensive therapy was taken by 75.7% of the women and 68.5% of the men but was not stopped on the The opinions expressed in this editorial are not necessarily those of the editors or of the American Heart Association.