Arterial Hypertension in Women: State of the Art and Knowledge Gaps
2023; Lippincott Williams & Wilkins; Volume: 80; Issue: 6 Linguagem: Inglês
10.1161/hypertensionaha.122.20448
ISSN1524-4563
AutoresNiamh Chapman, Siew Mooi Ching, А. О. Конради, Anne Monique Nuyt, Taskeen Khan, Betty Twumasi-Ankrah, Eun J. Cho, Aletta E. Schutte, Rhian M. Touyz, U. Muscha Steckelings, Lizzy M. Brewster,
Tópico(s)Sodium Intake and Health
ResumoHomeHypertensionVol. 80, No. 6Arterial Hypertension in Women: State of the Art and Knowledge Gaps No AccessReview ArticleRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplemental MaterialNo AccessReview ArticleRequest AccessFull TextArterial Hypertension in Women: State of the Art and Knowledge Gaps Niamh Chapman, Siew M. Ching, Aleksandra O. Konradi, Anne Monique Nuyt, Taskeen Khan, Betty Twumasi-Ankrah, Eun J. Cho, Aletta E. Schutte, Rhian M. Touyz, U. Muscha Steckelings and Lizzy M. Brewster Niamh ChapmanNiamh Chapman https://orcid.org/0000-0001-6317-5594 Menzies Institute for Medical Research, University of Tasmania, Australia (N.C.). , Siew M. ChingSiew M. Ching Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang (S.M.C.). , Aleksandra O. KonradiAleksandra O. Konradi https://orcid.org/0000-0001-8169-7812 Almazov National Medical Research Centre, S. Petersburg, Russia (A.O.K.). , Anne Monique NuytAnne Monique Nuyt https://orcid.org/0000-0003-3791-006X CHU Sainte-Justine Department of Pediatrics, Faculty of Medicine, Université de Montréal, Quebec, Canada (A.M.N.). , Taskeen KhanTaskeen Khan World Health Organization, Geneva, Switzerland (T.K.). , Betty Twumasi-AnkrahBetty Twumasi-Ankrah Life from 30 Foundation, Accra, Ghana (B.T.-A.). , Eun J. ChoEun J. Cho Division of Cardiology, Department of Internal medicine, Yeouido St. Mary's Hospital, Catholic University of Korea, Seoul (E.J.C.). , Aletta E. SchutteAletta E. Schutte https://orcid.org/0000-0001-9217-4937 School of Population Health, University of New South Wales, Sydney, Australia (A.E.S.). The George Institute for Global Health, Sydney, Australia (A.E.S.). , Rhian M. TouyzRhian M. Touyz https://orcid.org/0000-0003-0670-0887 Research Institute of the McGill University Health Centre (RI-MUHC), McGill University, Montréal, Québec, Canada (R.M.T.). , U. Muscha SteckelingsU. Muscha Steckelings https://orcid.org/0000-0002-5430-4275 Institute for Molecular Medicine, Department of Cardiovascular & Renal Research, University of Southern Denmark, Odense (U.M.S.). and Lizzy M. BrewsterLizzy M. Brewster Correspondence to: Lizzy M. Brewster, AIGHD and CK Research Foundation, The Netherlands. POB 23639, 1100 EC Amsterdam. Email E-mail Address: [email protected] https://orcid.org/0000-0002-7434-0038 Amsterdam Institute for Global Health and Development (AIGHD), the Netherlands (L.M.B.). CK Research Foundation, Amsterdam, the Netherlands (L.M.B.). Originally published15 Mar 2023https://doi.org/10.1161/HYPERTENSIONAHA.122.20448Hypertension. 2023;80:1140–1149AbstractHypertension is the leading risk factor for cardiovascular disease and premature death among women globally. However, there is a fundamental lack of knowledge regarding the sex-specific pathophysiology of the condition. In addition, risk factors for hypertension and cardiovascular disease unique to women or female sex are insufficiently acknowledged in clinical guidelines. This review summarizes the existing evidence on women and female-specific risk factors and clinical management of hypertension, to identify critical knowledge gaps relevant to research, clinical practice, and women's heart health awareness. Female-specific risk factors relate not only to reproduction, such as the association of gynecological conditions, adverse pregnancy outcomes or menopause with hypertension, but also to the specific roles of women in society and science, such as gender differences in received medical care and the underrepresentation of women in both the science workforce and as participants in research, which contribute to the limited evidence-based, gender- or sex-specific recommendations. A key point is that the development of hypertension starts in young, premenopausal women, often in association with disorders of reproductive organs, and therefore needs to be managed early in life to prevent future cardiovascular disease. Considering the lower blood pressure levels at which cardiovascular disease occurs, thresholds for diagnosis and treatment of hypertension may need to be lower for women.Footnotes*U.M. Steckelings and L.M. Brewster contributed equallyFor Sources of Funding and Disclosures, see page 1146.Supplemental Material is available at https://www.ahajournals.org/doi/suppl/10.1161/HYPERTENSIONAHA.122.20448.Correspondence to: Lizzy M. Brewster, AIGHD and CK Research Foundation, The Netherlands. POB 23639, 1100 EC Amsterdam. Email Hypertension@LizzyBrewster.netReferences1. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, et al. 2020 International society of hypertension global hypertension practice guidelines.Hypertension. 2020; 75:1334–1357. doi: 10.1161/hypertensionaha.120.15026LinkGoogle Scholar2. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension.Eur Heart J. 2018; 39:3021–3104. doi: 10.1093/eurheartj/ehy339CrossrefMedlineGoogle Scholar3. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults.J Am Coll Cardiol. 2018; 71:e127–e248. doi: 10.1016/j.jacc.2017.11.006CrossrefMedlineGoogle Scholar4. Wenger NK, Lloyd-Jones DM, Elkind MSV, Fonarow GC, Warner JJ, Alger HM, Cheng S, Kinzy C, Hall JL, Roger VL; American Heart Association. Call to action for cardiovascular disease in women: epidemiology, awareness, access, and delivery of equitable health care.Circulation. 2022; 145:e1059–e1071. doi: 10.1161/CIR.0000000000001071LinkGoogle Scholar5. Knight M, Bunch K, Vousden N, Banerjee A, Cox P, Cross-Sudworth F, Dhanjal MK, Douglas J, Girling J, Kenyon S, et al. A national cohort study and confidential enquiry to investigate ethnic disparities in maternal mortality.EClinicalMedicine. 2021; 43:101237. doi: 10.1016/j.eclinm.2021.101237CrossrefMedlineGoogle Scholar6. Vogel B, Acevedo M, Appelman Y, Bairey Merz CN, Chieffo A, Figtree GA, Guerrero M, Kunadian V, Lam CSP, Maas AHEM, et al. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030.Lancet. 2021; 397:2385–2438. doi: 10.1016/S0140-6736(21)00684-XCrossrefMedlineGoogle Scholar7. Reckelhoff JF. Gender differences in hypertension.Curr Opin Nephrol Hypertens. 2018; 27:176–181. doi: 10.1097/MNH.0000000000000404CrossrefMedlineGoogle Scholar8. Cho L, Davis M, Elgendy I, Epps K, Lindley KJ, Mehta PK, Michos ED, Minissian M, Pepine C, Vaccarino V, et al; ACC CVD Women's Committee Members. Summary of updated recommendations for primary prevention of cardiovascular disease in women.J Am Coll Cardiol. 2020; 75:2602–2618. doi: 10.1016/j.jacc.2020.03.060CrossrefMedlineGoogle Scholar9. Gerdts E, Sudano I, Brouwers S, Borghi C, Bruno RM, Ceconi C, Cornelissen V, Diévart F, Ferrini M, Kahan T, et al. Sex differences in arterial hypertension.Eur Heart J. 2022; 43:4777–4788. doi: 10.1093/eurheartj/ehac470CrossrefMedlineGoogle Scholar10. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019.Lancet. 2020; 396:1204–1222. doi: 10.1016/S0140-6736(20)30925-9CrossrefMedlineGoogle Scholar11. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.Lancet. 2021; 398:957–980. doi: 10.1016/S0140-6736(21)01330-1CrossrefMedlineGoogle Scholar12. Brewster LM, Haan Y, van Montfrans G. Cardiometabolic risk and cardiovascular disease in young women with uterine fibroids.Cureus. 2022; 14:e30740. doi: 10.7759/cureus.30740CrossrefMedlineGoogle Scholar13. Chen Y, Lin M, Guo P, Xiao J, Huang X, Xu L, Xiong N, O'Gara MC, O'Meara M, Tan X. Uterine fibroids increase the risk of hypertensive disorders of pregnancy: a prospective cohort study.J Hypertens. 2021; 39:1002–1008. doi: 10.1097/HJH.0000000000002729CrossrefMedlineGoogle Scholar14. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome.Fertil Steril. 2018; 110:364–379. doi: 10.1016/j.fertnstert.2018.05.004CrossrefMedlineGoogle Scholar15. Wu CH, Chiu LT, Chang YJ, Lee CI, Lee MS, Lee TH, Wei JC. Hypertension risk in young women with polycystic ovary syndrome: a nationwide population-based cohort study.Front Med (Lausanne). 2020; 7:574651. doi: 10.3389/fmed.2020.574651CrossrefMedlineGoogle Scholar16. Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA, Gunderson EP, Stuart JJ, Vaidya D, et al. Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women.Circulation. 2021; 143:e902–e916. doi: 10.1161/CIR.0000000000000961LinkGoogle Scholar17. Safar ME, Smulyan H. Hypertension in women.Am J Hypertens. 2004; 17:82–87. doi: 10.1016/s0895-7061(03)01008-2CrossrefMedlineGoogle Scholar18. Ji H, Kim A, Ebinger JE, Niiranen TJ, Claggett BL, Merz CNB, Cheng S. Sex differences in blood pressure trajectories over the life course.JAMA Cardiol. 2020; 5:19–26. doi: 10.1001/jamacardio.2019.5306CrossrefMedlineGoogle Scholar19. Wills AK, Lawlor DA, Matthews FE, Sayer AA, Bakra E, Ben-Shlomo Y, Benzeval M, Brunner E, Cooper R, Kivimaki M, et al. Life course trajectories of systolic blood pressure using longitudinal data from eight UK cohorts.PLoS Med. 2011; 8:e1000440. doi: 10.1371/journal.pmed.1000440CrossrefMedlineGoogle Scholar20. Murao S, Takata Y, Yasuda M, Osawa H, Kohi F. The influence of sodium and potassium intake and insulin resistance on blood pressure in normotensive individuals is more evident in women.Am J Hypertens. 2018; 31:876–885. doi: 10.1093/ajh/hpy041CrossrefMedlineGoogle Scholar21. Mihailidou AS, Gulati M, Maas AH. Improving compliance to antihypertensive treatment in women with hypertension.e-J Cardiol Pract. 2022; 22:5.Google Scholar22. Jin X, Chandramouli C, Allocco B, Gong E, Lam CSP, Yan LL. Women's participation in cardiovascular clinical trials from 2010 to 2017.Circulation. 2020; 141:540–548. doi: 10.1161/CIRCULATIONAHA.119.043594LinkGoogle Scholar23. Wang X, Carcel C, Woodward M, Schutte AE. Blood Pressure and stroke: a review of sex- and ethnic/racial-specific attributes to the epidemiology, pathophysiology, and management of raised blood pressure.Stroke. 2022; 53:1114–1133. doi: 10.1161/STROKEAHA.121.035852LinkGoogle Scholar24. Ji H, Niiranen TJ, Rader F, Henglin M, Kim A, Ebinger JE, Claggett B, Merz CNB, Cheng S. Sex differences in blood pressure associations with cardiovascular outcomes.Circulation. 2021; 143:761–763. doi: 10.1161/CIRCULATIONAHA.120.049360LinkGoogle Scholar25. Ford ND, Robbins CL, Hayes DK, Ko JY, Loustalot F. Prevalence, treatment, and control of hypertension among us women of reproductive age by race/hispanic origin.Am J Hypertens. 2022; 35:723–730. doi: 10.1093/ajh/hpac053CrossrefMedlineGoogle Scholar26. Schutte AE, Jafar TH, Poulter NR, Damasceno A, Khan NA, Nilsson PM, Alsaid J, Neupane D, Kario K, Beheiry H, et al. Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension.Cardiovasc Res. 2022;cvac130. doi: 10.1093/cvr/cvac130CrossrefGoogle Scholar27. Hägg S, Jylhävä J. Sex differences in biological aging with a focus on human studies.Elife. 2021; 10:e63425. doi: 10.7554/eLife.63425CrossrefMedlineGoogle Scholar28. Maas AH, Rosano G, Cifkova R, Chieffo A, van Dijken D, Hamoda H, Kunadian V, Laan E, Lambrinoudaki I, Maclaran K, et al. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists.Eur Heart J. 2021; 42:967–984. doi: 10.1093/eurheartj/ehaa1044CrossrefMedlineGoogle Scholar29. Muiesan ML, Paini A, Aggiusti C, Bertacchini F, Rosei CA, Salvetti M. Hypertension and organ damage in women.High Blood Press Cardiovasc Prev. 2018; 25:245–252. doi: 10.1007/s40292-018-0265-0CrossrefMedlineGoogle Scholar30. Brewster LM, Haan YC, Zwinderman AH, van den Born BJ, van Montfrans GA. CK (creatine kinase) is associated with cardiovascular hemodynamics: the HELIUS study.Hypertension. 2020; 76:373–380. doi: 10.1161/HYPERTENSIONAHA.120.14675LinkGoogle Scholar31. Picone DS, Kodithuwakku V, Mayer CC, Chapman N, Rehman S, Climie RE. Sex differences in pressure and flow waveform physiology across the life course.J Hypertens. 2022; 40:2373–2384. doi: 10.1097/HJH.0000000000003283CrossrefMedlineGoogle Scholar32. Morselli E, Santos RS, Criollo A, Nelson MD, Palmer BF, Clegg DJ. The effects of oestrogens and their receptors on cardiometabolic health.Nat Rev Endocrinol. 2017; 13:352–364. doi: 10.1038/nrendo.2017.12CrossrefMedlineGoogle Scholar33. Elmarakby AA, Sullivan JC. Sex differences in hypertension: lessons from spontaneously hypertensive rats (SHR).Clin Sci (Lond). 2021; 135:1791–1804. doi: 10.1042/CS20201017CrossrefMedlineGoogle Scholar34. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, et al; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial.JAMA. 2002; 288:321–333. doi: 10.1001/jama.288.3.321CrossrefMedlineGoogle Scholar35. Schulman IH, Aranda P, Raij L, Veronesi M, Aranda FJ, Martin R. Surgical menopause increases salt sensitivity of blood pressure.Hypertension. 2006; 47:1168–1174. doi: 10.1161/01.HYP.0000218857.67880.75LinkGoogle Scholar36. Faulkner JL, Belin de Chantemèle EJ. Sex differences in mechanisms of hypertension associated with obesity.Hypertension. 2018; 71:15–21. doi: 10.1161/HYPERTENSIONAHA.117.09980LinkGoogle Scholar37. Haan YC, Oudman I, Diemer FS, Karamat FA, van Valkengoed IG, van Montfrans GA, Brewster LM. Creatine kinase as a marker of obesity in a multi-ethnic population.Mol Cell Endocrinol. 2017; 442:24–31. doi: 10.1016/j.mce.2016.11.022CrossrefMedlineGoogle Scholar38. Ma D, Feitosa MF, Wilk JB, Laramie JM, Yu K, Leiendecker-Foster C, Myers RH, Province MA, Borecki IB. Leptin is associated with blood pressure and hypertension in women from the National Heart, Lung, and Blood Institute Family Heart Study.Hypertension. 2009; 53:473–479. doi: 10.1161/hypertensionaha.108.118133LinkGoogle Scholar39. Strzałkowska B, Dawidowicz M, Ochman B, Świętochowska E. The role of adipokines in leiomyomas development.Exp Mol Pathol. 2021; 123:104693. doi: 10.1016/j.yexmp.2021.104693CrossrefMedlineGoogle Scholar40. Soave I, Marci R. From obesity to uterine fibroids: an intricate network.Curr Med Res Opin. 2018; 34:1877–1879. doi: 10.1080/03007995.2018.1505606CrossrefMedlineGoogle Scholar41. Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A. Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update.Arch Gynecol Obstet. 2021; 303:631–643. doi: 10.1007/s00404-020-05951-2CrossrefMedlineGoogle Scholar42. Faulkner JL, Belin de Chantemèle EJ. Female sex, a major risk factor for salt-sensitive hypertension.Curr Hypertens Rep. 2020; 22:99. doi: 10.1007/s11906-020-01113-6CrossrefMedlineGoogle Scholar43. Strauss M, Smith W, Fedorova OV, Schutte AE. The Na+K+-ATPase inhibitor, Marinobufagenin, and early cardiovascular risk in humans: a review of recent evidence.Curr Hypertens Rep. 2019; 21:38. doi: 10.1007/s11906-019-0942-yCrossrefMedlineGoogle Scholar44. Steckelings UM, Widdop RE, Sturrock ED, Lubbe L, Hussain T, Kaschina E, Unger T, Hallberg A, Carey RM, Sumners C. The angiotensin AT 2 receptor: from a binding site to a novel therapeutic target.Pharmacol Rev. 2022; 74:10511–11135. doi: 10.1124/pharmrev.120.000281CrossrefGoogle Scholar45. Brewster LM, Perrotta ID, Jaggernath Z, Taherzadeh Z, van Montfrans GA. Ultrastructural changes in resistance arterioles of normotensive and hypertensive premenopausal women with uterine fibroids.Ultrastruct Pathol. 2023; 47:104–115. doi: 10.1080/01913123.2023.2171168CrossrefGoogle Scholar46. Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, et al. ESHRE guideline: endometriosis.Hum Reprod Open. 2022; 2022:hoac009. doi: 10.1093/hropen/hoac009CrossrefMedlineGoogle Scholar47. Mu F, Rich-Edwards J, Rimm EB, Spiegelman D, Forman JP, Missmer SA. Association between endometriosis and hypercholesterolemia or hypertension.Hypertension. 2017; 70:59–65. doi: 10.1161/HYPERTENSIONAHA.117.09056LinkGoogle Scholar48. Persu A, Dobrowolski P, Gornik HL, Olin JW, Adlam D, Azizi M, Boutouyrie P, Bruno RM, Boulanger M, Demoulin JB, et al. Current progress in clinical, molecular, and genetic aspects of adult fibromuscular dysplasia.Cardiovasc Res. 2022; 118:65–83. doi: 10.1093/cvr/cvab086CrossrefMedlineGoogle Scholar49. Canoy D, Beral V, Balkwill A, Wright FL, Kroll ME, Reeves GK, Green J, Cairns BJ; Million Women Study Collaborators*. Age at menarche and risks of coronary heart and other vascular diseases in a large UK cohort.Circulation. 2015; 131:237–244. doi: 10.1161/CIRCULATIONAHA.114.010070LinkGoogle Scholar50. Bertone-Johnson ER, Whitcomb BW, Rich-Edwards JW, Hankinson SE, Manson JE. Premenstrual syndrome and subsequent risk of hypertension in a prospective study.Am J Epidemiol. 2015; 182:1000–1009. doi: 10.1093/aje/kwv159CrossrefMedlineGoogle Scholar51. Chung HF, Ferreira I, Mishra GD. The association between menstrual symptoms and hypertension among young women: a prospective longitudinal study.Maturitas. 2021; 143:17–24. doi: 10.1016/j.maturitas.2020.08.006CrossrefMedlineGoogle Scholar52. Silberbach M, Roos-Hesselink JW, Andersen NH, Braverman AC, Brown N, Collins RT, De Backer J, Eagle KA, Hiratzka LF, Johnson WH, et al; American Heart Association Council on Cardiovascular Disease in the Young; Council on Genomic and Precision Medicine; and Council on Peripheral Vascular Disease. Cardiovascular health in Turner syndrome.Circ Genom Precis Med. 2018; 11:e000048. doi: 10.1161/HCG.0000000000000048LinkGoogle Scholar53. Khosla K, Heimberger S, Nieman KM, Tung A, Shahul S, Staff AC, Rana S. long-term cardiovascular disease risk in women after hypertensive disorders of pregnancy: recent advances in hypertension.Hypertension. 2021; 78:927–935. doi: 10.1161/HYPERTENSIONAHA.121.16506LinkGoogle Scholar54. Peters SA, Woodward M. Women's reproductive factors and incident cardiovascular disease in the UK Biobank.Heart. 2018; 104:1069–1075. doi: 10.1136/heartjnl-2017-312289CrossrefMedlineGoogle Scholar55. Tschiderer L, Seekircher L, Kunutsor SK, Peters SAE, O'Keeffe LM, Willeit P. Breastfeeding is associated with a reduced maternal cardiovascular risk: systematic review and meta-analysis involving data from 8 studies and 1 192 700 parous women.J Am Heart Assoc. 2022; 11:e022746. doi: 10.1161/JAHA.121.022746LinkGoogle Scholar56. El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause transition and cardiovascular disease risk: implications for timing of early prevention.Circulation. 2020; 142:e506–e532. doi: 10.1161/CIR.0000000000000912LinkGoogle Scholar57. Boggia J, Thijs L, Hansen TW, Li Y, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Jeppesen J, Torp-Pedersen C, et al; International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes Investigators. Ambulatory blood pressure monitoring in 9357 subjects from 11 populations highlights missed opportunities for cardiovascular prevention in women.Hypertension. 2011; 57:397–405. doi: 10.1161/HYPERTENSIONAHA.110.156828LinkGoogle Scholar58. Swaraj S, Kozor R, Arnott C, Di Bartolo BA, Figtree GA. Heart Failure with reduced ejection fraction-does sex matter?.Curr Heart Fail Rep. 2021; 18:345–352. doi: 10.1007/s11897-021-00533-yCrossrefMedlineGoogle Scholar59. Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, et al; American Heart Association Stroke Council. Guidelines for the prevention of stroke in women.Stroke. 2014; 45:1545–1588. doi: 10.1161/01.str.0000442009.06663.48LinkGoogle Scholar60. Gilsanz P, Mayeda ER, Glymour MM, Quesenberry CP, Mungas DM, DeCarli C, Dean A, Whitmer RA. Female sex, early-onset hypertension, and risk of dementia.Neurology. 2017; 89:1886–1893. doi: 10.1212/WNL.0000000000004602CrossrefMedlineGoogle Scholar61. Basit S, Wohlfahrt J, Boyd HA. Pre-eclampsia and risk of dementia later in life: nationwide cohort study.BMJ. 2018; 363:k4109. doi: 10.1136/bmj.k4109CrossrefMedlineGoogle Scholar62. Ortmann J, Nuesch E, Traupe T, Diehm N, Baumgartner I. Gender is an independent risk factor for distribution pattern and lesion morphology in chronic critical limb ischemia.J Vasc Surg. 2012; 55:98–104. doi: 10.1016/j.jvs.2011.07.074CrossrefMedlineGoogle Scholar63. Ross MB, Glennon BM, Murciano-Goroff R, Berkes EG, Weinberg BA, Lane JI. Women are credited less in science than men.Nature. 2022; 608:135–145. doi: 10.1038/s41586-022-04966-wCrossrefMedlineGoogle Scholar64. Bierer BE, Meloney LG, Ahmed HR, White SA. Advancing the inclusion of underrepresented women in clinical research.Cell Rep Med. 2022; 3:100553. doi: 10.1016/j.xcrm.2022.100553CrossrefMedlineGoogle Scholar65. National Academies of Sciences, Engineering, and Medicine. Baciu A, Negussie Y, Geller A, Weinstein JN, eds. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017:99–184. doi: 10.17226/24624CrossrefGoogle Scholar66. Ali M, van Os HJA, van der Weerd N, Schoones JW, Heymans MW, Kruyt ND, Visser MC, Wermer MJH. Sex differences in presentation of stroke: a systematic review and meta-analysis.Stroke. 2022; 53:345–354. doi: 10.1161/STROKEAHA.120.034040LinkGoogle Scholar67. Piazza MJ, Urbanetz AA. Environmental toxins and the impact of other endocrine disrupting chemicals in women's reproductive health.JBRA Assist Reprod. 2019; 23:154–164. doi: 10.5935/1518-0557.20190016CrossrefMedlineGoogle Scholar68. Michos ED, Nasir K, Braunstein JB, Rumberger JA, Budoff MJ, Post WS, Blumenthal RS. Framingham risk equation underestimates subclinical atherosclerosis risk in asymptomatic women.Atherosclerosis. 2006; 184:201–206. doi: 10.1016/j.atherosclerosis.2005.04.004CrossrefMedlineGoogle Scholar69. Brewster LM, Boermeester AS, Seedat YK, Van Montfrans GA. Initial combination therapy for hypertension in patients of African ancestry: a systematic review and meta-analysis.J Hypertens. 2022; 40:629–640. doi: 10.1097/HJH.0000000000003074CrossrefMedlineGoogle Scholar70. Fisher NM, Nieuwenhuis TO, Singh B, Yenokyan G, Segars JH. Angiotensin-converting enzyme inhibitors reduce uterine fibroid incidence in hypertensive women.J Clin Endocrinol Metab. 2021; 106:e650–e659. doi: 10.1210/clinem/dgaa718CrossrefMedlineGoogle Scholar71. Radosh L. Drug treatments for polycystic ovary syndrome.Am Fam Physician. 2009; 79:671–676.MedlineGoogle Scholar72. Turnbull F, Woodward M, Neal B, Barzi F, Ninomiya T, Chalmers J, Perkovic V, Li N, MacMahon S; Blood Pressure Lowering Treatment Trialists' Collaboration. Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials.Eur Heart J. 2008; 29:2669–2680. doi: 10.1093/eurheartj/ehn427CrossrefMedlineGoogle Scholar73. Picone DS, Stoneman E, Cremer A, Schultz MG, Otahal P, Hughes AD, Black JA, Bos WJ, Chen CH, Cheng HM, et al. Sex differences in blood pressure and potential implications for cardiovascular risk management.Hypertension. 2023; 80:316–324. doi: 10.1161/HYPERTENSIONAHA.122.19693LinkGoogle Scholar74. Kollias A, Lagou S, Zeniodi ME, Boubouchairopoulou N, Stergiou GS. Association of central versus brachial blood pressure with target-organ damage: systematic review and meta-analysis.Hypertension. 2016; 67:183–190. doi: 10.1161/HYPERTENSIONAHA.115.06066LinkGoogle Scholar75. Caudwell P, Gibbons C, Finlayson G, Näslund E, Blundell J. Exercise and weight loss: no sex differences in body weight response to exercise.Exerc Sport Sci Rev. 2014; 42:92–101. doi: 10.1249/JES.0000000000000019CrossrefMedlineGoogle Scholar76. Jones DW, Whelton PK, Allen N, Clark D, Gidding SS, Muntner P, Nesbitt S, Mitchell NS, Townsend R, Falkner B; American Heart Association Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; and Stroke Council. Management of stage 1 hypertension in adults with a low 10-year risk for cardiovascular disease: filling a guidance gap: a scientific statement from the American Heart Association.Hypertension. 2021; 77:e58–e67. doi: 10.1161/HYP.0000000000000195LinkGoogle Scholar77. Tamargo J, Rosano G, Walther T, Duarte J, Niessner A, Kaski JC, Ceconi C, Drexel H, Kjeldsen K, Savarese G, et al. Gender differences in the effects of cardiovascular drugs.Eur Heart J Cardiovasc Pharmacother. 2017; 3:163–182. doi: 10.1093/ehjcvp/pvw042CrossrefMedlineGoogle Scholar78. Tseng CH. Metformin use is associated with a lower risk of uterine leiomyoma in female type 2 diabetes patients.Ther Adv Endocrinol Metab. 2019; 10:2042018819895159. doi: 10.1177/2042018819895159CrossrefGoogle Scholar79. Qvarnström M, Kahan T, Kieler H, Brandt L, Hasselström J, Boström KB, Manhem K, Hjerpe P, Wettermark B. Persistence to antihypertensive drug classes: a cohort study using the Swedish Primary Care Cardiovascular Database (SPCCD).Medicine (Baltimore). 2016; 95:e4908. doi: 10.1097/MD.0000000000004908CrossrefMedlineGoogle Scholar80. Akasaka H, Yamamoto K, Rakugi H, Nagasawa M, Nakamaru R, Ichijo T, Takeda Y, Kurihara I, Katabami T, Tsuiki M, et al; Japan Primary Aldosteronism Study Group *. Sex difference in the association between subtype distribution and age at diagnosis in patients with primary aldosteronism.Hypertension. 2019; 74:368–374. doi: 10.1161/HYPERTENSIONAHA.119.13006LinkGoogle Scholar81. Saxena M, Schmieder RE, Kirtane AJ, Mahfoud F, Daemen J, Basile J, Lurz P, Gosse P, Sanghvi K, Fisher NDL, et al. Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study.J Hum Hypertens. 2022; 36:629–639. doi: 10.1038/s41371-021-00547-yCrossrefMedlineGoogle Scholar82. Heusser K, Tank J, Brinkmann J, Menne J, Kaufeld J, Linnenweber-Held S, Beige J, Wilhelmi M, Diedrich A, Haller H, et al. Acute response to unilateral unipolar electrical carotid sinus stimulation in patients with resistant arterial hypertension.Hypertension. 2016; 67:585–591. doi: 10.1161/HYPERTENSIONAHA.115.06486LinkGoogle Scholar83. Ascensão T, Leite HB, Matias S, Águas F. Arterial hypertension as an inaugural sign of myomatous uterus.BMJ Case Rep. 2021; 14:e243270. doi: 10.1136/bcr-2021-243270CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. 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Egan B, Mattix-Kramer H, Basile J and Sutherland S (2023) Managing Hypertension in Older Adults, Current Hypertension Reports, 10.1007/s11906-023-01289-7 Chang D, Ahmed S, Riehl-Tonn V, Kalenga C, Sola D and Dumanski S (2023) Awareness of Hypertension in Reproductive-Aged Women Living With Chronic Kidney Disease, CJC Open, 10.1016/j.cjco.2023.12.006, Online publication date: 1-Dec-2023. Shlyakhto E, Sukhikh G, Serov V, Dedov I, Arutyunov G, Suchkov I, Orlova Y, Andreeva E, Yureneva S, Yavelov I, Yarmolinskaya M, Villevalde S, Grigoryan O, Dudinskaya E, Ilyukhin E, Koziolova N, Sergienko I, Smetnik A and Tapilskaya N (2023) Russian eligibility criteria prescribing menopausal hormonal hormones therapy for patients with cardiovascular and metabolic diseases. Consensus document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russia, Problems of Endocrinology, 10.14341/probl13394, 69:5, (115-136) Shlyakhto E, Sukhikh G, Serov V, Dedov I, Arutyunov G, Suchkov I, Orlova Y, Andreeva E, Yureneva S, Yavelov I, Yarmolinskaya M, Villevalde S, Grigoryan O, Dudinskaya E, Ilyukhin E, Koziolova N, Sergienko I, Smetnik A and Tapilskaya N (2023) Russian Eligibility Criteria for Prescribing Menopausal Hormone Therapy to Patients With Cardiovascular and Metabolic Diseases. Consensus Document of RSC, RSOG, RAE, EUAT, RAP, Kardiologiia, 10.18087/cardio.2023.10.n2561, 63:10, (9-28) Manohar S, Charbonnet R, Reddy T and Ferdinand K (2023) Improving Hypertension Control in Vulnerable Populations Around the World, Current Cardiology Reports, 10.1007/s11886-023-01947-x, 25:10, (1319-1326), Online publication date: 1-Oct-2023. Elfassy T, German C, Muntner P, Choi E, Contreras G, Shimbo D and Yang E (2023) Blood Pressure and Cardiovascular Disease Mortality Among US Adults: A Sex-Stratified Analysis, 1999–2019, Hypertension, 80:7, (1452-1462), Online publication date: 1-Jul-2023. Brewster L, Perrotta I and van Montfrans G (2023) Should women have lower thresholds for hypertension diagnosis and treatment?, Journal of Human Hypertension, 10.1038/s41371-023-00838-6, 37:8, (753-754) June 2023Vol 80, Issue 6 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/HYPERTENSIONAHA.122.20448PMID: 36919603 Originally publishedMarch 15, 2023 Keywordscardiometabolic risk factorscardiovascular diseasegynecological diseasehypertensionmenopausepregnancywomenPDF download Advertisement SubjectsHigh Blood PressureHypertensionPreeclampsia
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