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[Is blood pressure control different in women than in men?]
A Oliveras1, L Sans-Atxer1, S Vázquez1
1Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitari del Mar; IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España.
Insights
Blood pressure (BP) management may differ by sex. Ambulatory BP monitoring, not just office BP, might reveal sex-specific cardiovascular risks, suggesting tailored BP goals for men and women.
Area of Science:
- Cardiology
- Hypertension Research
- Sex Differences in Health
Background:
- Blood pressure (BP) patterns change with age and sex, with higher BP in men before age 50, then in women.
- Despite similar controlled BP prevalence, women have higher cardiovascular disease (CVD) rates than men.
- The differing CVD prevalence suggests sex-specific influences of BP on cardiovascular risk.
Purpose of the Study:
- To investigate if blood pressure influences cardiovascular risk differently in men versus women.
- To explore the potential role of ambulatory BP monitoring versus office BP in identifying sex-specific risks.
- To evaluate the need for sex-specific blood pressure targets.
Main Methods:
- Analysis of existing studies examining BP, sex, and cardiovascular risk.
- Comparison of findings related to office BP measurements and ambulatory BP monitoring.
- Review of evidence on sex differences in the association between BP and CVD.
Main Results:
- Some studies show no sex difference in BP's cardiovascular risk impact, while others indicate higher risk in women at similar BP levels.
- Ambulatory BP monitoring, unlike office BP, appears to differentiate BP-gender associations with cardiovascular risk.
- Controlled BP prevalence is similar between sexes, yet CVD prevalence is higher in women.
Conclusions:
- Cardiovascular risk may be influenced differently by blood pressure according to sex.
- Ambulatory BP monitoring may be crucial for detecting sex-specific cardiovascular risks.
- Further investigation into sex-specific blood pressure goals, particularly using ambulatory BP, is warranted.
Abstract:
Blood pressure (BP) evolves with age; until the 50's it is higher in men than in women, equaling and even then increasing in women. The prevalence of controlled BP appears to be similar between the sexes, but the prevalence of cardiovascular disease is higher in women than in men. The possibility that BP influences the cardiovascular risk differently according to sex must therefore be considered. While some studies suggest no difference exists, others have shown evidence of an increased risk in women with respect to men despite equal BP. In this way, it seems that the measurement of ambulatory BP, but not office BP, would mark the differences in the association between BP-gender and cardiovascular risk. It should therefore be investigated the possibility of a different BP goal for women and men, especially by evaluating ambulatory BP.
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Physiological Factors:
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.