Gender-related differences in the progression of carotid stiffness with age and in the influence of risk factors on carotid stiffness

Background: In recent years, there has been growing interest in the impact of gender-related factors on the function and structure of the arterial tree. The aim of our study was to identify gender-specific differences in the progression of carotid stiffness parameters with age and in the impact of risk factors on carotid stiffness. Subjects and methods: The study group included 256 subjects (mean age: 54.7 years): 134 women (52%) and 122 men (48%) with cardiovascular risk factors: hypertension, type 2 diabetes mellitus, dyslipidemia, smoking, and obesity. Local parameters of carotid stiffness: beta stiffness index (beta), Peterson's elastic modulus (Ep), pulse wave velocity beta (PWV-beta) and arterial compliance (AC) were determined with ultrasound echo-tracking software application. Results: Women were characterized by lower AC than men (women: 0.57 mm(2)/kPa vs men: 0.69 mm(2)/kPa, p < 0.001) and the subanalysis in three age groups revealed that the difference in AC value between genders became significant over the age of 45 years. Although no significant difference in the value of beta, Ep and PWV-beta were found between genders in the whole study group, women <45 years were characterized by lower values of beta and Ep than their men counterparts (beta: women: 5.4 vs men: 6.6, p = 0.002; Ep: women: 72 kPa vs men: 84 kPa, p = 0.015). Among analyzed risk factors, the significant determinants of carotid stiffness were age, blood pressure components (pulse pressure and mean arterial pressure), type 2 diabetes mellitus and heart rate. The relationship between carotid stiffness and pulse pressure was observed only in women and between carotid stiffness and heart rate - only in men. Conclusion: There are gender-related differences in the progression of carotid stiffness parameters with age and in the influence of risk factors on carotid stiffness.