Sex differences in the use of blood pressure lowering therapy and blood pressure control

To investigate sex differences in the use of antihypertensive therapy and achievement of blood pressure targets among patients with hypertension in a real-world clinical setting.

Data were used from the PHARMO Data Network between 2010 and 2020. New users of antihypertensive medications with a diagnosis for hypertension were included. We assessed sex differences in antihypertensive intensity at initiation, time to first intensification, and achievement of blood pressure targets within 6 months after initiation.

In total, 24 851 individuals (48% women) were included. Women were 34% [95% confidence interval (CI): 27-42] more likely than men to be dispensed low intensity antihypertensives at initiation and to start with a beta-blocker or diuretic. Women were less likely than men to be uptitrated (adjusted hazard ratio: 0.93 (95% CI: 0.90-0.96)), yet 16% (95% CI: 11-20) more likely to reach blood pressure target levels.

Among individuals with hypertension, women initiated antihypertensive therapy at lower intensities and were less likely to be uptitrated than men. Nonetheless, attainment of blood pressure targets within 6 months after initiation was higher in women than men.