The influence of sex on left ventricular strain in hypertensive population

Marijana Tadic, Cesare Cuspidi, Vera Celic, Branislava Ivanovic, Biljana Pencic, Guido Grassi

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: The aim of this study was to evaluate the influence of sex on left ventricular mechanics in hypertensive individuals.

METHODS: This cross-sectional study included 171 untreated hypertensive patients and 112 normotensive controls who underwent a 24-h ambulatory blood pressure monitoring and comprehensive echocardiographic examination including strain assessment.

RESULTS: Hypertensive women and men had significantly lower left ventricular global longitudinal and circumferential strains than their normotensive counterparts. Left ventricular global longitudinal strain was lower in hypertensive men than in women (-19.8 ± 2.2 vs. -17.9 ± 2.1%; P < 0.01). Left ventricular global circumferential strain was also reduced in hypertensive men in comparison with women (-21.0 ± 2.5 vs. -18.7 ± 2.3%; P < 0.01). The difference in left ventricular radial strain was not discovered between hypertensive women and men. Furthermore, left ventricular twist was significantly higher in hypertensive women than in hypertensive men (21.9 ± 4.1° vs. 20.6 ± 3.8°; P = 0.034). Female sex and arterial hypertension, and also their interaction, were associated with lower left ventricular mass index, increased left ventricular global longitudinal, and circumferential strains and increased left ventricular twist compared with hypertensive men.

CONCLUSION: Left ventricular longitudinal and circumferential strains were significantly reduced in hypertensive patients. However, the changes are more pronounced in hypertensive men than in women. Sex has a significant effect on the association between hypertension, and longitudinal and circumferential strain.

Original languageEnglish
Pages (from-to)50-56
Number of pages7
JournalJournal of Hypertension
Issue number1
Publication statusPublished - Jan 2019


  • Blood Pressure/physiology
  • Blood Pressure Monitoring, Ambulatory
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Heart Ventricles/physiopathology
  • Humans
  • Hypertension/epidemiology
  • Male


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