• May 28, 2023

Pressure, in women the accuracy of the measurement can be influenced by height

You go, as is right, to the doctor. You do not suffer from the white coat effect, which perhaps pushes the pressure values ​​upwards. You sit quietly, the cuff rises on your arm and swells. Then the maximum, or the systolic, and minimum, the diastolic are measured. All normal, he will say. Yet even in this measurement that is repeated millions of times, there may be a possibility of error that does not depend on the attention of the person carrying out the check or on the functioning of the detector.

In women, in fact, there is a risk that the systolic values ​​found are slightly lower than the real ones, probably because the height is on average lower than male peers. And so you are likely to underestimate the situation.

The study on 500 people

To make us reflect in this sense are the results of an original observational study on 500 people, just under a third women, conducted by a team of the hospitals of the Universities of Montreal and Laval (first name Yasmine Abbaoui), Published on Jama Network Open.

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The research enrolled subjects without serious aortic valve problems or atrial fibrillation who had undergone coronary angiography, measuring systolic pressure at the beginning of the aorta, then immediately after the blood exits the heart, and regularly to the arm.

At first glance, considering only the values ​​found with the most common method, the systolic was similar in men and women, around 125 millimeters of mercury. But when we went to see what was happening in the vicinity of the heart, evaluating the pressure in the aorta, it was found that for women there was a significant difference of about 6 millimeters of mercury, which instead was not present in the male sex. In this sense, therefore, a substantial underestimation of the values ​​in the female sex was observed.

The shorter the stature, the greater the variation

But that’s not enough. To “mediate” this difference more than gender would be height, which led those who were shorter in stature to have more significant variations between the values ​​found in the arm and inside the aortic artery.

In short: sometimes the pressure can be deceiving, according to Canadian experts. And this data, especially in women of shorter stature, could help explain how women, even in the presence of blood pressure values ​​similar to men with normal measurement systems, can still be at greater cardiovascular risk. often without even imagining it.

The solution in an algorithm

Scholars therefore recommend studying specific algorithms for men and women, also considering tailor-made parameters such as stature that take into account these possible differences.

Heart door

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“The blood pressure that we usually consider in order to diagnose arterial hypertension and decide to start treatment is the non-invasive brachial one – he explains Claudio Ferri, full professor of Internal Medicine at the University of L’Aquila. However, the brachial arterial pressure, in fact, is different from the so-called central one, that is, recorded at the aortic level, particularly where the aortic is meant in the ascending aorta. “This, in particular, is of great interest for the upper vascular district and, therefore, , for the prevention of cerebrovascular events. “However, in the celebrated and celebrated study The Conduit Artery Function Evaluation (CAFE), as the substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) is known, the effective reduction of central blood pressure – a equal reduction in brachial arterial pressure – resulted in a better reduction of the entire primary composite outcome and renal events – replies the expert The greater reduction in central aortic pressure, therefore, protected the ASCOT-CAFE more effectively than to a lesser reduction not only the “superior” vascular districts compared to the ideal line that cuts the arch horizontally aortic, but also of the renal ones, that is to say very far from the aortic arch “.

Conclusion? According to Ferri, “it is clear that brachial arterial pressure is an excellent prognostic indicator, but largely perfectible, especially in terms of evaluating its fluctuations over time and its district specificity. In this context, the differences described in the study between men and women could explain the differences between the severity of coronary heart disease between the two genders and support the need to investigate much more deeply the harmful role of central arterial pressure and its correction “.

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