Long-term pharmacologic treatment of women with hypertension

As reviewed in "Hypertension in Women: What is Really Known?" (Women's Caucus Working Group on Women's Health of the Society of General Internal Medicine [1991] Ann Intern Med 115:287-293), the published literature reveals that hypertension frequently occurs in women and that only some prospective studies have defined specific benefits and risks of long-term pharmacologic treatment. Major U.S. epidemiologic studies show the incidence of hypertension to very between 20% and 50% of the population. It is more common among Afro-Americans than White Americans. Frequency increases with aging. Several studies of at least 3 years duration that have focused on the use of diuretics and B blockers are reviewed: Hypertension Detection and Follow-Up Program (HDFP), Medical Research Council (MRC), MRC trial in the treatment of older adults (MRC-Older), and isolated systolic hypertension in the elderly (SHEP). Both diuretics and B blockers generally lower blood pressure, and decrease stroke incidence and mortality. Diuretics seem to be more effective and better tolerated than B blockers. Long-term studies of newer antihypertensive agents do not yet exist. The sexual side effects of drugs have only been studied to a limited degree in women. © 1995 Wiley-Liss, Inc.