Women Need Earlier, More Aggressive Hypertension Treatment
Winston-Salem, NC—High blood pressure creates more vascular disease in women than men and needs to be treated earlier and more aggressively, according to a new study.
In the study, published recently in Therapeutic Advances in Cardiovascular Disease, Wake Forest University School of Medicine researchers uncovered significant gender differences in the mechanisms that cause high blood pressure.
“The medical community thought that high blood pressure was the same for both sexes and treatment was based on that premise,” said lead author Carlos Ferrario, MD. “This is the first study to consider sex as an element in the selection of anti-hypertensive agents or base the choice of a specific drug on the various factors accounting for the elevation in blood pressure.”
Ferrario noted that the significant decline in cardiovascular disease mortality in men during the last 20 to 30 years has not been seen in women, where heart disease has become the third leading cause of death in the United States.
He and his coauthors questioned why results were different when men and women had been treated in the same way for the same condition. To try to determine the answer, the researchers evaluated 100 men and women age 53 and older with untreated high blood pressure and no other major diseases, using noninvasive impedance cardiography, applanation tonometry and plasma measures of angiotensin II, angiotensin (1–7), serum aldosterone, high-sensitivity C-reactive protein (hs-CRP), and cytokine biomarkers of inflammation.
Based on the hemodynamic and hormonal characteristics determined through testing, results revealed 30% to 40% more vascular disease in the women compared to the men for the same level of elevated blood pressure.
In addition, the women’s cardiovascular systems demonstrated significant physiologic differences, including types and levels of hormones involved in blood pressure regulation, that contribute to the severity and frequency of heart disease.
“The impact of sex differences in the hemodynamic factors accounting for the elevation in arterial pressure in subjects with essential hypertension has been poorly characterized or this information is not available,” study authors point out.
“Our study findings suggest a need to better understand the female sex-specific underpinnings of the hypertensive processes to tailor optimal treatments for this vulnerable population,” Ferrario added. “We need to evaluate new protocols—what drugs, in what combination and in what dosage—to treat women with high blood pressure.”