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Gender-specific therapeutic approach in arterial hypertension - Challenges ahead
Marijana Tadic1, Cesare Cuspidi2, Guido Grassi3
1Charité - Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Augustenburgerplatz 1, 13353, Berlin, Germany.
Insights
While hypertension is often seen as a greater risk in men, women face higher rates of related cardiovascular diseases, especially post-menopause. Understanding gender differences in hypertension treatment is crucial for effective therapy.
Area of Science:
- Cardiology
- Pharmacology
- Endocrinology
Background:
- Arterial hypertension is a significant cardiovascular risk factor, with historical focus on male prevalence.
- Women, particularly during menopause, exhibit a higher incidence of hypertension and its complications.
- Observed differences in antihypertensive medication efficacy between genders necessitate further investigation.
Purpose of the Study:
- To review current knowledge on gender-specific differences in hypertension prevalence and awareness.
- To explore sex-based alterations in hypertension pathophysiology.
- To evaluate the impact of gender on the effectiveness of major antihypertensive drug classes.
Main Methods:
- Comprehensive literature review of observational studies and clinical trials.
- Analysis of data concerning gender disparities in hypertension prevalence and awareness.
- Examination of pathophysiological mechanisms influenced by sex hormones, the renin-angiotensin-aldosterone system, and sympathetic nervous system.
- Assessment of sex-specific responses to various antihypertensive medication groups.
Main Results:
- Overall incidence of hypertension-related cardiovascular diseases is higher in women than in men.
- Hypertension prevalence and complications rise sharply in women during menopause.
- Current data on the impact of gender on antihypertensive medication effects are inconsistent.
- Potential gender-specific differences in blood pressure control and treatment response exist due to hormonal and physiological factors.
Conclusions:
- Significant gender differences in hypertension prevalence, pathophysiology, and treatment response warrant further research.
- Longitudinal studies focusing on gender and antihypertensive drug efficacy are needed.
- A deeper understanding of these variations can optimize therapeutic approaches and improve cost-effectiveness in managing hypertension for both genders.
Abstract:
Hypertension was thought to be more important cardiovascular risk factor in men than in women. However, studies showed that overall incidence of hypertension-related cardiovascular diseases is higher in women comparing with men and this is particularly valid in menopause when prevalence of hypertension and its complications sharply and suddenly rises. It was also noticed that the effect of various antihypertensive groups was different in women and men. Some medications are prescribed more often in women, but it does not necessary mean that these drugs are more effective in this gender. There are several important reasons that could explain gender-induced differences in blood pressure levels, blood pressure control and antihypertensive treatment. They involve sex hormones, the renin-angiotensin-aldosterone and sympathetic nervous system, and arterial stiffness. However, taking into account many observational studies and trials, there are no consistent data regarding the impact of gender on effect of antihypertensive medications. Longitudinal study focused on gender and current antihypertensive groups would significantly help to understand the impact of gender. This might change therapeutic approach and improve cost-effectiveness in antihypertensive therapy in both genders. A full understanding of the pathophysiological characteristics of variations between genders demands additional research. This review article summarized the current knowledge regarding differences in the prevalence and awareness of arterial hypertension in women and men; alterations in pathophysiological mechanisms of hypertension between sexes; as well as the impact of sex on the effects of main antihypertensive groups of medications.
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