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Arterial hypertension in the female world: pathophysiology and therapy

Christian Cadeddu1, Flavia Franconi, Laura Cassisa

  • 1aDepartment of Medical Sciences 'M. Aresu', University of Cagliari bDepartment of Biomedical Sciences, University of Sassari cCardiology Complex Unit, Marino Hospital - ASL Cagliari Marino - ASL Cagliari dDepartment of Biomedical Sciences, University of Sassari; National Laboratory of Gender Medicine of the National Institute of Biostructures and Biosystems, Osilo, Sassari eCMR Unit, Fondazione G. Monasterio CNR-Regione Toscana fFondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology-CNR, Pisa gDepartment of Neuroscience, Imaging and Clinical Sciences, University of Chieti, Pescara hDepartment of Cardiovascular and Respiratory Sciences, University of Rome 'La Sapienza', Italy.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|February 25, 2016
PubMed

Insights

Hypertension management in women faces challenges due to sex-specific factors and underrepresentation in trials. Understanding these differences is key for effective blood pressure control and cardiovascular health.

Area of Science:

  • Cardiology
  • Pharmacology
  • Women's Health

Background:

  • Hypertension poses significant cardiovascular risks, particularly in women, with suboptimal blood pressure (BP) control remaining a critical issue.
  • Sex-specific factors may contribute to BP variations and treatment outcomes in women, who have historically been underrepresented in clinical trials.
  • Limited research on women's cardiovascular health and antihypertensive therapies necessitates further investigation into sex-based differences.

Purpose of the Study:

  • To explore the multifactorial reasons behind sex differences in blood pressure (BP) levels.
  • To investigate the underrepresentation of women in clinical trials and its impact on understanding antihypertensive therapy outcomes.
  • To examine the disparities in antihypertensive drug utilization between men and women.

Main Methods:

  • Review of existing literature on sex differences in hypertension and cardiovascular disease.
  • Analysis of epidemiological data on antihypertensive medication use in men and women.
  • Exploration of potential pathophysiological mechanisms, including hormonal, renin-angiotensin system, sympathetic activity, and arterial stiffness.

Main Results:

  • Hypertension control is often suboptimal in women, potentially linked to sex-specific factors.
  • Women are underrepresented in clinical trials, limiting data on treatment efficacy and safety.
  • Significant differences exist in antihypertensive drug prescriptions between sexes: women more frequently use diuretics and ARBs, while men receive beta-blockers, CCBs, or ACE inhibitors.

Conclusions:

  • Sex-specific factors significantly influence hypertension and cardiovascular outcomes in women.
  • Further research is crucial to elucidate the pathophysiological basis of sex differences in BP regulation and treatment response.
  • Understanding these disparities is essential for developing tailored antihypertensive strategies for women.

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