High Blood Pressure May Be More Dangerous for Women

A new study has identified significant differences in the mechanisms that cause high blood pressure in women, as compared to men.

Researchers at Wake Forest Baptist Medical Center (Winston-Salem, NC, USA) conducted a study involving 100 men and women age 53 and older (39% women) with untreated high blood pressure and no other major diseases. The researchers then utilized noninvasive impedance cardiography, applanation tonometry, and plasma measures of angiotensin II, angiotensin (1–7), serum aldosterone, high-sensitivity C-reactive protein (hs-CRP), and cytokine biomarkers of inflammation to characterize the hemodynamic and hormonal profile of the patients.

The results showed that despite there being no differences between women and men in terms of office blood pressure, heart rate, and body mass index (BMI), men demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity and augmentation index. In all, women had 30%–40% more vascular disease than men for the same level of elevated blood pressure. In addition, there were significant physiologic and hormonal differences in the women's cardiovascular system that contributed to the severity and frequency of heart disease.

In each of the hypertension categories, the increased blood pressure in men was associated with significant augmentations in stroke volume and cardiac output compared with women. Sex-related hemodynamic differences were associated in women with higher plasma levels of leptin, hs-CRP, plasma angiotensin II and serum aldosterone, and no differences in the serum concentrations of cytokinins. The study was published in the December 2013 issue of Therapeutic Advances in Cardiovascular Disease.

“The medical community thought that high blood pressure was the same for both sexes and treatment was based on that premise,” said lead author professor Carlos Ferrario, MD. “This is the first study to consider sex as an element in the selection of antihypertensive agents or base the choice of a specific drug on the various factors accounting for the elevation in blood pressure.”

“Our study findings suggest a need to better understand the female sex-specific underpinnings of the hypertensive processes to tailor optimal treatments for this vulnerable population,” added Dr. Ferrario. “We need to evaluate new protocols–what drugs, in what combination, and in what dosage—to treat women with high blood pressure.”

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Wake Forest Baptist Medical Center