91 Shorter stature in women is a driver of sex-differences in the prevalence of heart failure with preserved ejection fraction

Background Altered ventricular-vascular coupling (VVC) is a key mechanism in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). Arterial elastance (Ea), an integral component of VVC, has a static and pulsatile component which could be affected by the physical differences in men and women. We hypothesised differences in height may explain some of the sex-differences in pulsatile load, which has been linked to the development of HFpEF. Methods We retrospectively analysed echocardiographic data from a large prospective community study of people aged >60 years. Height, arterial elastance (Ea), the pulsatile and static components of Ea (total arterial compliance (TAC) and systemic vascular resistance (SVR)), were calculated and compared between the sexes and across three groups: HFpEF, hypertensive (HTN) controls, and healthy controls. Results There were 142 HFpEF patients (73±7 years, 74% female), 725 HTN controls (70±7 years, 49% female) and 205 healthy controls (67±5 years, 59% female) (Table 1). There was a significant correlation between TAC and height in the participants as a group (r=0.218, p Height was only an independent predictor of TAC when controlling for sex in HTN controls (β=0.11, p=0.047). Women were shorter than men (p Conclusions Women have significantly higher Ea and lower TAC. In both men and women with hypertension, a taller stature was independently associated with reduced pulsatile arterial load and Ea. Women are more susceptible to the deleterious effects of low TAC, which may partly explain the sex differences in the prevalence of HFpEF. Conflict of Interest None