Sex- and Gender-Based Reporting in Antihypertensive Medication Literature Informing Hypertension Guidelines

Area of Science:

• Cardiovascular Research
• Medical Literature Analysis
• Sex and Gender in Medicine

Background:

• Hypertension is a primary modifiable cardiovascular risk factor.
• Significant sex- and gender-based differences exist in hypertension.
• Existing literature informing hypertension guidelines lacks adequate sex and gender reporting.

Purpose of the Study:

• To assess the incorporation of sex and gender reporting in studies on antihypertensive medications.
• To evaluate how research cited in major hypertension guidelines addresses sex and gender differences.

Main Methods:

• Systematic review of literature cited in international hypertension guidelines.
• Inclusion of observational studies, randomized controlled trials, and systematic reviews on antihypertensive medications.
• Exclusion of single-sex studies, guidelines, and commentaries.
• Extraction of data on sex participation ratios, demographic/outcome analysis by sex, and adverse event stratification by sex.

Main Results:

• Of 331 included studies, 81% reported participant sex, but only 22% had a balanced male-to-female participation ratio.
• Only 3% stratified baseline characteristics by sex, and 20% considered sex in analysis.
• While 32% reported adverse events, a mere 0.6% stratified them by sex.
• Most studies (58%) used "sex" and "gender" interchangeably.

Conclusions:

• Sex and gender considerations are inadequately incorporated into research on antihypertensive medications.
• There is a critical need for improved sex- and gender-based analysis in research.
• Enhanced research is essential for optimal hypertension management informed by sex and gender differences.