Nobakht Niloofar, Afshar Yalda, Vaseghi Marmar, Li Zhaoping, Donangelo Ines, Lavretsky Helen, Mok Thalia, Han Christina S, Nicholas Susanne B
Division of Nephrology, Department of Medicine, at the David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, at the David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Mayo Clin Proc. 2025 Mar;100(3):514-533. doi: 10.1016/j.mayocp.2024.10.005. Epub 2024 Dec 29.
Current clinical practice guidelines were established by several organizations to guide the diagnosis and treatment of hypertension in men and women in a similar manner despite data demonstrating differences in underlying mechanisms. Few publications have provided a contemporary and comprehensive review focused on characteristics of hypertension that are unique to women across their life spectrum. We performed a computerized search using PubMed, OVID, EMBASE, and Cochrane library databases between 1995 and 2023 that highlighted relevant clinical studies, challenges to the management of hypertension in women, and multidisciplinary approaches to hypertension control in women, including issues unique to racial and ethnic minority groups. Despite our current understanding of underlying mechanisms and strategies to manage hypertension in women, numerous challenges remain. Here, we discuss potential factors contributing to hypertension in women, differences related to effects of lifestyle modifications and drug therapy between men and women, the impact of sleep, and the importance of recognizing disparities in socioeconomic conditions and access to care. This review outlines several opportunities for future studies to fill gaps in knowledge to achieve optimal control of hypertension in women using a multidisciplinary approach, particularly related to sex-specific treatment approaches while considering socioeconomic conditions and life stages from premenopause through the transition to menopause.
尽管有数据表明男女高血压的潜在机制存在差异,但多个组织制定了当前的临床实践指南,以类似方式指导男性和女性高血压的诊断和治疗。很少有出版物对女性一生中特有的高血压特征进行当代全面综述。我们使用PubMed、OVID、EMBASE和Cochrane图书馆数据库在1995年至2023年期间进行了计算机检索,重点关注相关临床研究、女性高血压管理面临的挑战以及女性高血压控制的多学科方法,包括种族和少数族裔群体特有的问题。尽管我们目前对女性高血压的潜在机制和管理策略有所了解,但仍存在许多挑战。在此,我们讨论导致女性高血压的潜在因素、男女在生活方式改变和药物治疗效果方面的差异、睡眠的影响以及认识社会经济状况差异和获得医疗服务机会的重要性。本综述概述了未来研究的几个机会,以填补知识空白,通过多学科方法实现女性高血压的最佳控制,特别是在考虑社会经济状况和从绝经前到绝经过渡的生命阶段时采用针对性别的治疗方法。