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Age-dependent gender differences in hypertension management
Stacie L Daugherty1, Frederick A Masoudi, Jennifer L Ellis
1Division of Cardiology, 12605 E, 16th Avenue, Mailstop B130, PO Box 6511, Aurora, CO 80045, USA. stacie.daugherty@ucdenver.edu
Insights
Hypertension control varies by age and gender. Younger men and older women showed lower rates of controlled blood pressure compared to their peers. Further research is needed to improve hypertension management for all.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- Despite gender-neutral hypertension guidelines, disparities in hypertension control persist, potentially varying with age.
- Previous research indicates potential gender-based differences in hypertension management and outcomes.
Purpose of the Study:
- To compare hypertension control rates between women and men across different age groups.
- To investigate the influence of age on gender-related differences in hypertension control.
Main Methods:
- Analysis of incident hypertension cases within three integrated healthcare systems (2001-2007).
- Hypertension control defined by guideline-recommended blood pressure levels within one year of diagnosis.
- Multivariable logistic regression models used to assess gender and age associations with hypertension outcomes.
Main Results:
- The cohort comprised 152,561 patients with incident hypertension; 55.6% were women.
- Overall, men had slightly lower hypertension control rates than women (41.2% vs. 45.7%).
- A significant gender-by-age interaction revealed younger men (18-49) had 17% lower odds and older men (≥65) had 12% higher odds of control compared to women.
Conclusions:
- Hypertension control rates differ significantly by age and gender, with younger men and older women facing greater challenges.
- These findings highlight the need for age-specific strategies to optimize hypertension management.
- Further investigation into the underlying reasons for age-related gender disparities in hypertension control is warranted.
Objective:
Despite gender-neutral guidelines, prior studies suggest that women have lower rates of hypertension control and these differences may vary with age. Accordingly, we compared rates of hypertension control between women and men as a function of age.
Methods:
Within three integrated healthcare systems in the Cardiovascular Research Network, we studied all patients seen from 2001 to 2007 with incident hypertension. Within 1 year of cohort entry, patient's hypertension was categorized as controlled based upon achieving guideline-recommended blood pressure levels, recognized if hypertension was diagnosed or a hypertension medication dispensed, and treated based on hypertension medications dispensed. Multivariable logistic regression models assessed the association between gender and 1-year hypertension outcomes, adjusted for patient characteristics.
Results:
Among the 152,561 patients with incident hypertension, 55.6% were women. Compared to men, women were older, had more kidney disease and more blood pressure measures during follow-up. Overall, men tended to have lower rates of hypertension control compared to women (41.2 vs. 45.7%, adjusted odds ratio 0.93, 95% confidence interval 0.91-0.95). A significant gender by age interaction was found with men aged 18-49 having 17% lower odds of hypertension control and men aged at least 65 having 12% higher odds of hypertension control compared to women of similar ages (P<0.001).
Conclusion:
In this incident hypertension cohort, younger men and older women had lower rates of hypertension control compared to similarly aged peers. Future studies should investigate why gender differences vary by age in order to plan appropriate means of improving hypertension management regardless of gender or age.
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