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Pathophysiological aspects of hypertensive disease in women
Guido Grassi1, Gino Seravalle, Maria Luisa Stella
1Università Milano-Bicocca, Ospedale San Gerardo, Istituto Auxologico Italiano, Centro di Fisiologia Clinica ed Ipertensione, Milan, Italy.
Insights
Essential hypertension mechanisms remain unclear, even in women. While some gender-specific factors exist, the overall pathophysiology of hypertension shows few significant differences between men and women before menopause.
Area of Science:
- Cardiovascular Science
- Hypertension Research
- Gender Medicine
Background:
- Significant advancements in understanding essential hypertension pathophysiology over two decades.
- Basic mechanisms driving hypertension development and progression remain largely undefined.
- Hypertension in women presents unique challenges, with identified gender-specific hemodynamic, vascular, metabolic, and neurohumoral factors.
Purpose of the Study:
- To examine gender-specific differences in hemodynamic, vascular, metabolic, and neurohumoral profiles.
- To compare normotensive and hypertensive females with age-matched males.
- To elucidate the role of gender in hypertension pathophysiology.
Main Methods:
- Comparative analysis of physiological profiles between genders.
- Review of existing literature on hemodynamic, vascular, metabolic, and neurohumoral factors.
- Focus on differences in normotensive and hypertensive states.
Main Results:
- Identified several hemodynamic, vascular, metabolic, and neurohumoral factors with gender-specific associations.
- Observed clear-cut differences between genders in specific parameters.
- Found overall similarities in the pathophysiological picture of hypertension between sexes before menopause.
Conclusions:
- While some gender-specific factors are noted, the fundamental pathophysiology of hypertension is largely similar in men and women.
- Menopausal hormonal changes may represent a significant divergence point in gender-specific hypertension development.
- Further research is needed to fully define gender-specific mechanisms in hypertension.
Abstract:
Although during the past two decades there has been considerable progress in the understanding of the pathophysiology of human essential hypertension, the basic mechanisms responsible for the development and progression of the disease still remain largely undefined. This also applies to the pathophysiology of hypertension in women, although a number of haemodynamic, vascular, metabolic and neurohumoral factors have been identified throughout the years as being characterized by a gender-specific relation. This paper will examine the main differences in the haemodynamic, vascular, metabolic and neurohumoral profile characterizing normotensive as well as hypertensive females as compared with age-matched males. Although in some instances clearcut differences between genders can be found, overall the pathophysiological picture of the hypertensive state does not seem to have significant differences in men and women, at least up to the years when the menopausal-related hormonal changes take place.