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Sex differences in essential hypertension

I Os1, S E Kjeldsen, G Nordby

  • 1Department of Internal Medicine, Ullevål Hospital, University of Oslo, Norway.

Journal of Internal Medicine
|January 1, 1993
PubMed
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Hypertensive men exhibit greater athero-thrombogenic risk factors than women. Obese hypertensive women show decreased sympathetic activity, suggesting distinct hypertension mechanisms and potential weight gain risks.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Hypertension affects men and women differently, with varying risk factors.
  • Understanding sex-based differences in hypertension pathophysiology is crucial for targeted treatment.
  • Lipid profiles and sympathetic nervous system activity are key indicators of cardiovascular risk.

Purpose of the Study:

  • To compare athero-thrombogenic risk factors in untreated hypertensive men and women of similar age and body mass index.
  • To investigate the relationship between body mass index, plasma catecholamines, and metabolic factors in hypertensive individuals.
  • To explore potential differences in the pathophysiological mechanisms of hypertension between lean and obese hypertensive women.

Main Methods:

  • Comparative analysis of blood pressure, lipid profiles, hemoglobin, hematocrit, and plasma catecholamines in hypertensive men and women.

Related Experiment Videos

  • Statistical correlation analysis to determine relationships between body mass index, plasma catecholamines (noradrenaline, adrenaline), and insulin.
  • Stratification of women by body mass index (above vs. below 25 kg m-2) to assess sympathetic activity differences.

    • Main Results:

    • Hypertensive men displayed a more atherogenic lipid profile (lower HDL, higher total cholesterol and triglycerides) and higher hemoglobin/hematocrit compared to women.
    • Plasma catecholamines were inversely related to body mass index in women only.
    • Obese hypertensive women (BMI > 25 kg m-2) had significantly lower plasma adrenaline and noradrenaline levels than leaner hypertensive women.
    • A negative curvilinear relationship was observed between arterial adrenaline and insulin levels.

    Conclusions:

    • Hypertensive men have a greater propensity for athero-thrombogenic risk factors compared to similarly aged and hypertensive women.
    • Metabolic risk factors appear closely interrelated even within the normal range in hypertensive women.
    • Decreased sympathetic activity in obese hypertensive women suggests different pathophysiological mechanisms, potentially linked to reduced energy expenditure and weight gain, and may explain the inverse insulin-adrenaline relationship.