Copyright © L ippincott W illiams & W ilkins. U nauthorized r eproduction o f t his a rticle i s p rohibited. ElderlyAlgerian women lose their sex-advantage in terms of arterial stiffness and cardiovascular profile Mohamed Temmar a , Ghassan Watfa b,c,d , Laure Joly b,c,d , Anna Kearney-Schwartz b,d , Merabia Youcef e , Selt Bensalah f , Yahia Mustapha g , Paolo Salvi h , Sylvie Gautier b,d , Michel Safar i , Carlos Labat c , and Athanase Benetos b,c,d Objectives: Several studies have shown lower carotid– femoral pulse wave velocity (cfPWV) levels in women compared to men, a difference that could partially explain the increased longevity in women. However, these studies have been performed in industrial countries while few data are available in emerging populations. We studied arterial stiffness, as evaluated by cfPWV, in elderly Algerian men and women. Methods: cfPWV was studied in 321 Algerian men (81.2  5.3 years) and women (81.1  4.4 years). An age- matched and sex-matched cohort of European individuals (n ¼ 321) was used as a control group. Results: Comparatively to men, Algerian women exhibited higher BMI and heart rate (HR), higher prevalence of hypertension, and were more frequently treated for hypertension. cfPWV was not different between Algerian men (14.8  3.3 m/s) and women (14.9  3.4 m/s). By contrast, in Europeans, women had lower cfPWV (12.7  2.7 m/s) than men (14.0  3.3 m/s; P <0.001). Comparatively to European women, Algerian women had a higher cfPWV (P <0.01). In both ethnic groups, multivariate analyses revealed that age, mean blood pressure (BP), HR, and diabetes were positively associated with cfPWV, whereas female sex was associated with lower cfPWV only in Europeans. Conclusion: Elderly Algerian women exhibit arterial stiffness similar to men, whereas European women display lower arterial stiffness than men. This loss of ‘arterial sex advantage’ in Algerians may be explained by higher BP, HR, and a worse metabolic profile in Algerian women. Interventions in emerging populations, especially in women, should be a priority in order to address these risk factors by acting on current lifestyle. Keywords: aging, Algerian, arterial stiffness, European, sex, pulse wave velocity Abbreviations: ADL, activities of daily living; cfPWV, carotid–femoral pulse wave velocity; CVD, cardiovascular disease; EPWVD, elderly pulse wave velocity database; HR, heart rate; MBP, mean blood pressure; MetS, metabolic syndrome; MMSE, Mini-Mental State Examination; PP, pulse pressure INTRODUCTION C arotid–femoral pulse wave velocity (cfPWV) is currently considered as the ‘gold standard’ measure- ment of arterial stiffness, and is an independent predictor of cardiovascular morbidity and mortality [1–5]. Recent studies conducted primarily in industrial countries have shown the interest of evaluating PWV in the elderly. Groups of elderly people with high PWV show higher risk of cognitive decline [6–8] and increased cardio- vascular morbidity and mortality [2,9]. However, very little is known regarding arterial stiffness during the aging process in emerging populations. What is known, however, is that with the ongoing sociodemographic changes occur- ring in these countries and the decrease in early mortality, cardiovascular morbidity and mortality are both dramatic- ally on the rise. Indeed, recent epidemiological studies have shown that in emerging populations such as in northern Africa, hypertension [10–12], diabetes [13], and metabolic syndrome (MetS) [12] have become epidemic. As these factors are considered as major determinants of accelerated arterial aging [14–16], the study of arterial stiffness could contribute to better assess cardiovascular risk in these populations. Some but not all clinical studies have shown lower PWV levels in elderly women as compared to men [17–19] and this difference could at least partially explain better cardiovascular profiles and increased longevity in women. However, all of these studies have been performed in industrial countries while few or no data are available in emerging populations. The aim of the present study was to evaluate the sex- related differences in arterial stiffness as evaluated by cfPWV in Algerian elderly individuals and to compare these Journal of Hypertension 2013, 31:000–000 a Cardiology Centre, Ghardaia, Algeria, b Department of Geriatrics, University Hospital of Nancy, c Faculty of Medicine, Inserm U961, d Universite ´ de Lorraine, Nancy, France, e El Menia Hospital, f Directorate of Health, g Diabetes Center, Ghardaia, Algeria, h Department of Cardiology, IRCCS Istituto Auxologico Italiano, Milan, Italy and i AP-HP, Paris Descartes University, Diagnosis and Therapeutic Center, Ho ˆ tel-Dieu, Paris, France Correspondence to Professor Athanase Benetos, MD, PhD, Head of Department of Geriatrics, University Hospital of Nancy, 54500 Vandoeuvre le ` s Nancy, France. Tel: +33 383 15 33 22; fax: +33 383 15 76 68; e-mail: a.benetos@chu-nancy.fr Received 20 March 2013 Revised 22 May 2013 Accepted 24 May 2013 J Hypertens 31:000–000 ß 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. DOI:10.1097/HJH.0b013e3283639460 Journal of Hypertension www.jhypertension.com 1 Original Article