Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada.
Faculty of Medicine, McGill University, Montreal, QC, Canada.
J Hum Hypertens. 2023 Aug;37(8):589-595. doi: 10.1038/s41371-022-00789-4. Epub 2022 Dec 12.
Hypertension (HTN) is a critical primary modifiable risk factor for the development of cardiovascular diseases, with recognized sex-based differences. While sex refers to one's biological genetic makeup and attributes, gender encompasses the individual's psycho-socio-cultural characteristics, including their environment and living conditions. The impact of each gendered variable may differ amongst men and women with respect to HTN. Applying a sex and gender-based lenses to inform our understanding of HTN has the potential to unveil important contributors of HTN-related cardiovascular outcomes. For instance, increased life stressors, work related anxiety and depression, typically have more pronounced effect on women than men with HTN. The impact of social surrounding including marital status and social support on HTN also differs amongst men and women. While married men are less likely to have higher blood pressure, single women, and those who never married are less likely to have HTN. Additionally, the beneficial role of social support is more pronounced in more historically marginalized cultural groups compared to majority. Finally, socioeconomic status, including education level and income have a linear and inverse relationship in blood pressure control in more resource-rich countries. The aim of this review is to summarize how sex and gender interact in shaping the clinical course of HTN demonstrating the importance of both sex and gender in HTN risk and its treatment. Hence, when investigating the role of gendered factors in HTN it is imperative to consider cultural, and social settings. In this narrative we found that employment and education play a significant role in manifestation and control of HTN particularly in women.
高血压（HTN）是心血管疾病发展的关键可调节的主要危险因素，其存在明确的性别差异。虽然性别是指一个人的生物遗传构成和属性，但性别包含了个体的心理社会文化特征，包括其环境和生活条件。每个性别变量对 HTN 的影响在男性和女性之间可能不同。从性别视角来理解 HTN，有潜力揭示与 HTN 相关心血管结局的重要影响因素。例如，生活压力、与工作相关的焦虑和抑郁等因素对 HTN 女性的影响通常比男性更为显著。社会环境包括婚姻状况和社会支持对 HTN 的影响在男性和女性之间也存在差异。已婚男性患高血压的可能性较低，而单身女性和从未结婚的女性患高血压的可能性较低。此外，社会支持的有益作用在历史上处于边缘地位的文化群体中比在多数群体中更为明显。最后，在资源更丰富的国家，社会经济地位，包括教育水平和收入，与血压控制呈线性反比关系。本综述的目的是总结性别和性别如何相互作用，塑造 HTN 的临床过程，展示性别和性别在 HTN 风险及其治疗中的重要性。因此，在研究性别因素在 HTN 中的作用时，必须考虑文化和社会背景。在本综述中，我们发现就业和教育在 HTN 的表现和控制中起着重要作用，特别是在女性中。
