| Summary: | Objectives: Sex differences for parameters of arterial wave reflection and arterial stiffness were reported from single office measurements, but circadian patterns were not extensively investigated up to now. The aim of this study was to determine sex differences between day and night values of ambulatory central blood pressure as well as ambulatory pulse wave parameters related to arterial wave reflection.
Methods: A Mobil-O-Graph (IEM, Stolberg) with inbuilt PWA technology was used in patients without antihypertensive treatment visiting a doctor’s practice for internal medicine. Aortic blood pressure was obtained using a generalized transfer function incorporating mean blood pressure for pressure calibration. Daytime was defined between 9 am and 8 pm and nighttime between 10 pm and 6 am.
Results: In the study 192 men (mean age 50.5 years) and 155 women (57.3 years) were included. Men had higher central systolic (cSBP) and diastolic blood pressures compared to women. In contrast, augmentation index (AIx) and reflection magnitude (RM) were significantly lower in men compared to women both during day and night. For both sexes, AIx and RM were higher during the night, see table for full details (all day-night differences were statistically significant).
Day
Night
Men
Women
Men
Women
bSBP (mmHg)
134.5*
130.2
121.5
118.6
bDBP (mmHg)
86.7*
81.5
74.8*
70.3
HR (bpm)
75.2
77.1
64.5*
66.9
cSBP (mmHg)
136.7*
131.5
131.7*
125.4
AIx (%)
19.8*
28.2
25.1*
35.1
RM
60.5*
63.4
68.7*
71.4
*Indicates a significant difference between men and women (p < 0.05); bSBP – brachial systolic blood pressure, bDBP – brachial diastolic blood pressure, HR – heart rate, cSBP – central systolic blood pressure, AIx – augmentation index, RM – reflection magnitude.
TableMean values of both sexes during daytime and nighttime.
Conclusions: A typical blood pressure dipping during nighttime was found for both sexes. However, an increase in wave reflection parameters was found during nighttime leading to highest values for women during the night. Thus, single measurements have to be interpreted with caution and an ambulatory blood pressure measurement including pulse wave analysis might be beneficial.
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