In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism

Background Arterial hypertension is characterized by microvasculature changes and reduced tissue perfusion. It is unknown whether a sexual dimorphism of renal microcirculation is present in patients with arterial hypertension. We aimed to compare the cortical microcirculation in women and men with h...

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Main Authors: Aikaterini Damianaki, Mariëlle Hendriks‐Balk, Wendy Brito, Erietta Polychronopoulou, Kenji Theiler, Menno Pruijm, Grégoire Wuerzner
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.039306
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author Aikaterini Damianaki
Mariëlle Hendriks‐Balk
Wendy Brito
Erietta Polychronopoulou
Kenji Theiler
Menno Pruijm
Grégoire Wuerzner
author_facet Aikaterini Damianaki
Mariëlle Hendriks‐Balk
Wendy Brito
Erietta Polychronopoulou
Kenji Theiler
Menno Pruijm
Grégoire Wuerzner
author_sort Aikaterini Damianaki
collection DOAJ
description Background Arterial hypertension is characterized by microvasculature changes and reduced tissue perfusion. It is unknown whether a sexual dimorphism of renal microcirculation is present in patients with arterial hypertension. We aimed to compare the cortical microcirculation in women and men with hypertension and to evaluate their response to sympathetic stimulation with a cold pressor test (CPT). Methods The cortical perfusion index (PI) measured by contrast‐enhanced ultrasonography was used as a proxy of renal microcirculation. We measured the PI at rest and during a 2‐minute CPT in patients with arterial hypertension. We used a linear mixed‐model analysis to study the effect of sex, the CPT, and their interaction on the PI. Results Thirty‐two participants were included (34% women). Age and body mass index were similar in both groups. Median PI was higher in women (2344 [interquartile range, 1553–2685 arbitrary units]) than men (1285 [interquartile range, 591–1741 arbitrary units], P=0.009). The CPT increased the PI in both groups; however, the magnitude of the response to CPT was similar in both sexes. Conclusions Women with arterial hypertension have a higher cortical microperfusion than men, while their microvascular reactivity to a CPT appears to be similar. This sexual dimorphism may have an impact on renal function decline, which needs further investigation.
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spelling doaj-art-942a921a678e4cce801182489b44304a2025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.039306In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual DimorphismAikaterini Damianaki0Mariëlle Hendriks‐Balk1Wendy Brito2Erietta Polychronopoulou3Kenji Theiler4Menno Pruijm5Grégoire Wuerzner6Service of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandService of Nephrology and Hypertension Lausanne University Hospital and University of Lausanne Lausanne SwitzerlandBackground Arterial hypertension is characterized by microvasculature changes and reduced tissue perfusion. It is unknown whether a sexual dimorphism of renal microcirculation is present in patients with arterial hypertension. We aimed to compare the cortical microcirculation in women and men with hypertension and to evaluate their response to sympathetic stimulation with a cold pressor test (CPT). Methods The cortical perfusion index (PI) measured by contrast‐enhanced ultrasonography was used as a proxy of renal microcirculation. We measured the PI at rest and during a 2‐minute CPT in patients with arterial hypertension. We used a linear mixed‐model analysis to study the effect of sex, the CPT, and their interaction on the PI. Results Thirty‐two participants were included (34% women). Age and body mass index were similar in both groups. Median PI was higher in women (2344 [interquartile range, 1553–2685 arbitrary units]) than men (1285 [interquartile range, 591–1741 arbitrary units], P=0.009). The CPT increased the PI in both groups; however, the magnitude of the response to CPT was similar in both sexes. Conclusions Women with arterial hypertension have a higher cortical microperfusion than men, while their microvascular reactivity to a CPT appears to be similar. This sexual dimorphism may have an impact on renal function decline, which needs further investigation.https://www.ahajournals.org/doi/10.1161/JAHA.124.039306contrast‐enhanced ultrasoundhypertensionkidneymicrocirculationperfusion indexsex differences
spellingShingle Aikaterini Damianaki
Mariëlle Hendriks‐Balk
Wendy Brito
Erietta Polychronopoulou
Kenji Theiler
Menno Pruijm
Grégoire Wuerzner
In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
contrast‐enhanced ultrasound
hypertension
kidney
microcirculation
perfusion index
sex differences
title In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
title_full In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
title_fullStr In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
title_full_unstemmed In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
title_short In Patients With Hypertension, the Cortical Perfusion Index Measured by Contrast Enhanced Ultrasound Reveals a Sexual Dimorphism
title_sort in patients with hypertension the cortical perfusion index measured by contrast enhanced ultrasound reveals a sexual dimorphism
topic contrast‐enhanced ultrasound
hypertension
kidney
microcirculation
perfusion index
sex differences
url https://www.ahajournals.org/doi/10.1161/JAHA.124.039306
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