Gender Differences in Antihypertensive Treatment: Myths or Legends?

High Blood Press Cardiovasc Prev. 2016 Jun;23(2):105-13. doi: 10.1007/s40292-016-0148-1. Epub 2016 Apr 22.

Abstract

In European countries and in the USA, hypertension represents an important risk factor for cardiovascular diseases (CVD) in men and women. Women do not perceive CVD as an important health problem, despite the evidence that women are more at risk to die from hypertension-related CVD than men. A correct prevention strategy should more widely acknowledge sex-specific risk factors, such as hypertension in pregnancy, and the benefit of treating hypertension in both men and women. In more recent years, hypertension awareness and treatment rates are higher in women than in men while blood pressure control rates are improving, but remain still lower in older hypertensive women. Differences have been described regarding the pattern of antihypertensive drug prescription and use in hypertensive men and women; women are more frequently treated with diuretics and less frequently with angiotensin-converting-enzyme (ACE)-inhibitors and angiotensin-receptors blockers. Calcium-antagonists appear to be particularly effective in women. Data from large clinical trials and meta-analyses offer strong evidence that the efficacy of the various drug classes in prevention of CV events does not differ by sex, and therefore the choice of the drug cannot be based only on this criterion in post- menopausal women. There are currently no specific blood pressure (BP) treatment goals for post-menopausal hypertension.

Keywords: Blood pressure; Gender; Hypertension; Treatment; Women; sex.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Status Disparities*
  • Healthcare Disparities*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Male
  • Postmenopause
  • Practice Guidelines as Topic
  • Prevalence
  • Risk Factors
  • Sex Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents