Division of Nephrology, Thomas Jefferson University, 833 Chestnut Street, Suite 800, Philadelphia, PA, 19102, USA.
Curr Hypertens Rep. 2019 Aug 26;21(10):74. doi: 10.1007/s11906-019-0979-y.
To examine available clinical data on the differences between premenopausal and postmenopausal women with hypertension (HTN). Clinical conditions related to HTN and reproductive status differ in younger women compared with older women. Due to recent changes in the definition of HTN, the prevalence of HTN has increased significantly in all women. Rising rates of obesity among women of all ages increase the risk for HTN.
Among younger women, long-term vascular consequences of preeclampsia, the under-reported prevalence of fibromuscular dysplasia, and widespread use of oral contraceptive pills in women with contraindications confer unique risks for HTN-related cardiovascular risk. For older women, insights on vascular aging and hormonal changes with menopause are shown to be gender-specific causal factors for HTN. Assessment of risk factors unique to premenopausal and postmenopausal women can facilitate the management of HTN and improve long-term outcomes. Further studies in women are needed to accurately stratify women risk based on these risk factors.
研究绝经前和绝经后高血压(HTN)女性之间的临床差异的现有数据。与老年女性相比,年轻女性的 HTN 相关临床情况和生殖状态存在差异。由于 HTN 定义的最近变化,所有女性的 HTN 患病率显著增加。所有年龄段女性肥胖率的上升增加了 HTN 的风险。
在年轻女性中,子痫前期的长期血管后果、纤维肌性发育不良发病率低报以及有禁忌症的女性广泛使用避孕药会带来与 HTN 相关心血管风险的独特风险。对于老年女性,血管老化和绝经后激素变化的研究表明是 HTN 的特定性别因果因素。评估绝经前和绝经后女性特有的危险因素可以促进 HTN 的管理并改善长期结局。需要进一步的女性研究来根据这些危险因素准确分层女性的风险。