Sex-Related Disparities in Cardiovascular Outcomes Among Older Adults With Late-Onset Hypertension

Area of Science:

• Cardiology
• Geriatrics
• Epidemiology

Background:

• Sex-based differences in cardiovascular outcomes for late-onset hypertension remain unclear.
• Late-onset hypertension is a significant concern in aging populations.

Purpose of the Study:

• To investigate sex-based differences in cardiovascular outcomes among older adults with newly diagnosed hypertension.
• To determine the incidence of major adverse cardiovascular events and mortality by sex in this demographic.

Main Methods:

• Population-based cohort study in Ontario, Canada, including 266,273 adults aged 66+ with new hypertension.
• Utilized Cox proportional hazard models to analyze the incidence of composite cardiovascular outcomes (myocardial infarction, stroke, heart failure), all-cause mortality, and cardiovascular death by sex.
• Adjusted for demographic factors and comorbidities, including competing risks.

Main Results:

• Females (51%) had a lower crude incidence rate for the primary composite cardiovascular outcome, all-cause mortality, and cardiovascular death compared to males.
• Adjusted analyses revealed a significantly lower risk of the primary composite cardiovascular outcome in females (aHR, 0.75; 95% CI, 0.73-0.76).
• This finding remained consistent after adjusting for the competing risk of all-cause death (SHR, 0.88; 95% CI, 0.86-0.91).

Conclusions:

• Females with newly diagnosed, late-onset hypertension exhibit a lower risk of cardiovascular outcomes compared to males.
• Sex influences the severity of cardiovascular outcomes in relation to the age of hypertension diagnosis.
• Further research is needed to understand sex-specific variations in the diagnosis and management of late-onset hypertension.