Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.
Curr Atheroscler Rep. 2018 Feb 14;20(3):13. doi: 10.1007/s11883-018-0716-z.
This review aims to examine gender differences in both the epidemiology and pathophysiology of hypertension and to explore gender peculiarities on the effects of antihypertensive agents in decreasing BP and CV events.
Men and women differ in prevalence, awareness, and control rate of hypertension in an age-dependent manner. Studies suggest that sex hormones changes play a pivotal role in the pathophysiology of hypertension in postmenopausal women. Estrogens influence the vascular system inducing vasodilatation, inhibiting vascular remodeling processes, and modulating the renin-angiotensin aldosterone system and the sympathetic system. This leads to a protective effect on arterial stiffness during reproductive age that is dramatically reversed after menopause. Data on the efficacy of antihypertensive therapy between genders are conflicting, and the underrepresentation of aged women in large clinical trials could influence the results. Therefore, further clinical research is needed to uncover potential gender differences in hypertension to promote the development of a gender-oriented approach to antihypertensive treatment.
本文旨在探讨高血压的流行病学和病理生理学中的性别差异，并探讨降压药物在降低血压和心血管事件方面的性别特异性影响。
男性和女性的高血压患病率、知晓率和控制率随年龄增长而不同。研究表明，性激素变化在绝经后女性高血压的病理生理学中起着关键作用。雌激素影响血管系统，引起血管舒张，抑制血管重塑过程，并调节肾素-血管紧张素-醛固酮系统和交感神经系统。这对生殖年龄期间的动脉僵硬产生保护作用，而绝经后这种保护作用则急剧逆转。关于性别之间降压治疗效果的数据存在矛盾，并且大型临床试验中年龄较大的女性代表性不足可能会影响结果。因此，需要进一步的临床研究来揭示高血压中潜在的性别差异，以促进针对降压治疗的性别导向方法的发展。
