Noninvasive Assessment of Sex Differences in Arterial Load in Healthy Adults

Background Women have higher risk of heart failure than their male counterparts. Although the mechanical inefficiency of myocardium against an excessive afterload is an important reason of heart failure, little attention has been paid to the sex differences in arterial load and its clinical relevance. Results The effective arterial elastance index (EaI), total arterial compliance index (TACI), and systemic vascular resistance index (SVRI) were determined using transthoracic echocardiography combined with cuff-measured brachial blood pressure in 460 healthy adults (230 men). The sex differences in these arterial load indexes were analyzed. No statistical difference was found in the age, heart rate, and stroke volume index (all P < 0.05). After adjustment for the cuff-measured blood pressure; the estimated marginal means (95% CIs) of the EaI was higher in women than in men [0.972 (0.952–0.991) vs 0.743 (0.724–0.763) mmHg m 2 /mL, P < 0.001], the TACI was lower in women than in men [0.924 (0.905–0.944) vs 1.055 (1.036–1.075) mL/mm Hg m 2 , P < 0.001], and no statistical difference was found in the SVRI between sexes ( P > 0.05). Conclusions For any given cuff-measured blood pressure, greater integrated and pulsatile arterial load are imposed on left ventricle in women than in men, which is a piece of evidence that women have higher risk of heart failure than their counterparts.