Sex differences in hypertension. Do we need a sex-specific guideline?
Hypertension is the most prevalent cardiovascular disorder and the leading cause of death worldwide in both sexes. The prevalence of hypertension is lower in premenopausal women than in men of the same age, but sharply increases after the menopause, resulting in higher rates in women aged 65 and old...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.960336/full |
| _version_ | 1811339496575205376 |
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| author | Renata Cífková Renata Cífková Larysa Strilchuk Larysa Strilchuk |
| author_facet | Renata Cífková Renata Cífková Larysa Strilchuk Larysa Strilchuk |
| author_sort | Renata Cífková |
| collection | DOAJ |
| description | Hypertension is the most prevalent cardiovascular disorder and the leading cause of death worldwide in both sexes. The prevalence of hypertension is lower in premenopausal women than in men of the same age, but sharply increases after the menopause, resulting in higher rates in women aged 65 and older. Awareness, treatment, and control of hypertension are better in women. A sex-pooled analysis from 4 community-based cohort studies found increasing cardiovascular risk beginning at lower systolic blood pressure thresholds for women than men. Hormonal changes after the menopause play a substantial role in the pathophysiology of hypertension in postmenopausal women. Female-specific causes of hypertension such as the use of contraceptive agents and assisted reproductive technologies have been identified. Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality, as well as with a greater risk of developing cardiovascular disease later in life. Hypertension-mediated organ damage was found to be more prevalent in women, thus increasing the cardiovascular risk. Sex differences in pharmacokinetics have been observed, but their clinical implications are still a matter of debate. There are currently no sufficient data to support sex-based differences in the efficacy of antihypertensive treatment. Adverse drug reactions are more frequently reported in women. Women are still underrepresented in large clinical trials in hypertension, and not all of them report sex-specific results. Therefore, it is of utmost importance to oblige scientists to include women in clinical trials and to consider sex as a biological variable. |
| first_indexed | 2024-04-13T18:27:31Z |
| format | Article |
| id | doaj.art-844a58e01c5c462d9a3a50045f83f5eb |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T18:27:31Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-844a58e01c5c462d9a3a50045f83f5eb2022-12-22T02:35:12ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.960336960336Sex differences in hypertension. Do we need a sex-specific guideline?Renata Cífková0Renata Cífková1Larysa Strilchuk2Larysa Strilchuk3Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, Prague, CzechiaDepartment of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, CzechiaCenter for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, Prague, CzechiaDepartment of Therapy No 1, Medical Diagnostics, Hematology and Transfusiology, Lviv Danylo Halytsky National Medical University, Lviv, UkraineHypertension is the most prevalent cardiovascular disorder and the leading cause of death worldwide in both sexes. The prevalence of hypertension is lower in premenopausal women than in men of the same age, but sharply increases after the menopause, resulting in higher rates in women aged 65 and older. Awareness, treatment, and control of hypertension are better in women. A sex-pooled analysis from 4 community-based cohort studies found increasing cardiovascular risk beginning at lower systolic blood pressure thresholds for women than men. Hormonal changes after the menopause play a substantial role in the pathophysiology of hypertension in postmenopausal women. Female-specific causes of hypertension such as the use of contraceptive agents and assisted reproductive technologies have been identified. Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality, as well as with a greater risk of developing cardiovascular disease later in life. Hypertension-mediated organ damage was found to be more prevalent in women, thus increasing the cardiovascular risk. Sex differences in pharmacokinetics have been observed, but their clinical implications are still a matter of debate. There are currently no sufficient data to support sex-based differences in the efficacy of antihypertensive treatment. Adverse drug reactions are more frequently reported in women. Women are still underrepresented in large clinical trials in hypertension, and not all of them report sex-specific results. Therefore, it is of utmost importance to oblige scientists to include women in clinical trials and to consider sex as a biological variable.https://www.frontiersin.org/articles/10.3389/fcvm.2022.960336/fullepidemiology of hypertensioncardiovascular riskwhite coat hypertensionmasked hypertensionpolycystic ovary syndromecontraceptive agents |
| spellingShingle | Renata Cífková Renata Cífková Larysa Strilchuk Larysa Strilchuk Sex differences in hypertension. Do we need a sex-specific guideline? Frontiers in Cardiovascular Medicine epidemiology of hypertension cardiovascular risk white coat hypertension masked hypertension polycystic ovary syndrome contraceptive agents |
| title | Sex differences in hypertension. Do we need a sex-specific guideline? |
| title_full | Sex differences in hypertension. Do we need a sex-specific guideline? |
| title_fullStr | Sex differences in hypertension. Do we need a sex-specific guideline? |
| title_full_unstemmed | Sex differences in hypertension. Do we need a sex-specific guideline? |
| title_short | Sex differences in hypertension. Do we need a sex-specific guideline? |
| title_sort | sex differences in hypertension do we need a sex specific guideline |
| topic | epidemiology of hypertension cardiovascular risk white coat hypertension masked hypertension polycystic ovary syndrome contraceptive agents |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.960336/full |
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