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Sex-Specific Blood Pressure Thresholds in Middle-Aged Adults
Katie Williams1,2, Benjamin Grobman1,2, Fredrick Larbi Kwapong1
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.W., B.G., F.L.K., H.C., R.-A.N.T.-O., L.H.N., M.Z., S.P.J.).
Hypertension (Dallas, Tex. : 1979)
|January 14, 2026
Summary
This study found no significant sex differences in cardiovascular disease (CVD) risk or blood pressure (BP) distribution among middle-aged adults. The findings do not support the need for sex-specific hypertension thresholds.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Existing research suggests higher cardiovascular disease (CVD) risk in women at lower blood pressure (BP) thresholds, prompting discussion on sex-specific hypertension guidelines.
- However, the clinical significance of these observations requires further investigation in diverse populations.
Purpose of the Study:
- To investigate potential sex differences in blood pressure (BP) distribution, cardiovascular disease (CVD) risk, and risk factor burden.
- To evaluate whether current hypertension thresholds are appropriate for both male and female adults.
Main Methods:
- Utilized data from the Atherosclerosis Risk in Communities (ARIC) study, visit 1 (1987-1989).
- Compared BP distribution, 10-year CVD risk scores, absolute risk, and relative risk of CVD between sexes.
- Stratified analyses by hypertension treatment status in participants without prior CVD.
Main Results:
- The study included 13,418 participants (56% women), with 25% receiving hypertension treatment.
- No consistent differences were observed in BP distribution, CVD risk factors, absolute risk, or relative risk of CVD between male and female adults.
- Males exhibited higher average 10-year CVD risk scores irrespective of treatment status.
Conclusions:
- The findings do not support the implementation of sex-specific hypertension thresholds in this middle-aged population.
- Further research may be needed to explore potential sex differences in CVD risk across different age groups and ethnicities.
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