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Differences in ambulatory blood pressure between men and women with mild hypertension
H Eison1, R A Phillips, M Ardeljan
1Hypertension Division, Mount Sinai Medical Centre, New York, NY 10029-6574.
Insights
Ambulatory blood pressure monitoring revealed that mild hypertension is less severe in women than men during daily activities. This finding may explain the lower long-term cardiovascular risks observed in hypertensive women.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Trials
Background:
- Mild, uncomplicated hypertension requires accurate blood pressure assessment.
- Ambulatory blood pressure monitoring (ABPM) offers a more realistic measure than clinic readings.
- Sex differences in hypertension prevalence and outcomes are well-documented.
Purpose of the Study:
- To compare ambulatory blood pressure readings between men and women with mild hypertension.
- To investigate potential sex-based differences in blood pressure control during daily life.
- To explore the implications of these differences for cardiovascular morbidity.
Main Methods:
- Non-invasive ABPM was conducted on 87 subjects with newly diagnosed mild hypertension.
- Exclusion criteria included obesity, diabetes, and secondary hypertension.
- Blood pressure was monitored during a typical day of activity.
Main Results:
- Average ambulatory systolic and diastolic pressures were lower than clinic/initial readings.
- Men exhibited significantly higher average ambulatory systolic pressure than women.
- Women showed a higher proportion with controlled blood pressure (<140/90 mmHg) compared to men.
Conclusions:
- Women with mild hypertension demonstrate lower average systolic blood pressure during daily activities compared to men.
- These sex-specific ambulatory pressure differences may contribute to lower cardiovascular morbidity in hypertensive women.
- ABPM is crucial for accurate hypertension assessment, revealing sex-based variations.
Abstract:
Non-invasive ambulatory blood pressure monitoring was performed in a consecutive series of 87 subjects with recently detected mild uncomplicated hypertension. Obese subjects, diabetics and those with secondary hypertension were excluded. Ambulatory pressures were recorded on a day of usual activity. Average ambulatory systolic and diastolic pressures were significantly lower than referral pressures determined in clinics or screening sites and initial pressures taken by the monitors. Whereas men (57) and women (30) had similar referral and initial pressures, average ambulatory systolic pressure was significantly higher in men; diastolic pressure was not different. Men also had a significantly higher fraction of ambulatory systolic pressures greater than 140 mmHg compared to women. Fifty-six percent of the men and 80% of the women had average ambulatory systolic pressures less than 140 mmHg and diastolic pressures less than 90 mmHg; the difference between the sexes was significant (chi 2 = 6.99, P less than 0.01). Thus, in mild hypertension, women have lower average systolic pressure than men during ordinary daily activity. These results may account for lower long-term cardiovascular morbidity in hypertensive women compared with men.