Egan Brent M, Li Jiexiang, Sutherland Susan E, Riesser Benjamin C, Mattix-Kramer Holly, Rakotz Michael K
American Medical Association, Improving Health Outcomes, Greenville, SC (B.M.E.,S.E.S., B.C.R.).
College of Charleston, Department of Mathematics, Charleston, SC (J.L.).
Hypertension. 2025 Nov;82(11):1857-1865. doi: 10.1161/HYPERTENSIONAHA.125.25535. Epub 2025 Sep 22.
Differences in height may contribute to higher systolic blood pressure values and lower hypertension control rates in older women than men.
National Health and Nutrition Examination Surveys cross-sectional data from 2005 to 2006 through 2017 to 2020 were analyzed on women (n=1682) and men (n=1468), aged ≥75 years with hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or antihypertensive pharmacotherapy). The association of height and sociobiological variables (body mass index, education, income, chronic kidney disease, cardiovascular disease, diabetes, statin therapy) with sex differences in systolic blood pressure was assessed by multivariable linear regression, and their association with hypertension control was assessed by multivariable logistic regression. Data are presented as mean (95% CI).
Systolic blood pressure was higher in older women than men (145.8 mm Hg [144.5-147.1] versus 139.3 mm Hg [138.1-140.6]; <0.001). Women were shorter than men (1.57 [1.56-1.57] versus 1.71 [1.71-1.72] meters; <0.0001). Adjusting for height eliminated sex differences in systolic blood pressure (6.4 mm Hg [5.0-7.9] unadjusted versus -0.6 mm Hg [-3.1-1.9] height adjusted), whereas adjusting for sociobiological variables did not (5.0 mm Hg [3.4-6.6]). Hypertension control to <140/<90 mm Hg was less frequent in women than men (38.0% [35.2-40.7] versus 47.1% [43.7-50.5]; <0.001). The lower odds ratio for hypertension control in women than men (0.69 [0.60-0.79] unadjusted) was eliminated after adjusting for height (1.12 [0.91-1.36]), but not after adjusting for sociobiological variables (0.73 [0.63-0.85]).
Shorter stature in older women than men is associated with higher systolic blood pressure and lesser hypertension control.
与男性相比，老年女性身高差异可能导致收缩压值更高且高血压控制率更低。
分析了2005年至2006年至2017年至2020年的国家健康和营养检查调查的横断面数据，研究对象为年龄≥75岁的高血压女性（n = 1682）和男性（n = 1468）（收缩压≥140 mmHg或舒张压≥90 mmHg或接受抗高血压药物治疗）。通过多变量线性回归评估身高和社会生物学变量（体重指数、教育程度、收入、慢性肾病、心血管疾病、糖尿病、他汀类药物治疗）与收缩压性别差异之间的关联，并通过多变量逻辑回归评估它们与高血压控制之间的关联。数据以均值（95%可信区间）表示。
老年女性的收缩压高于男性（145.8 mmHg [144.5 - 147.1] 对 139.3 mmHg [138.1 - 140.6]；P<0.001）。女性比男性矮（1.57 [1.56 - 1.57] 米对 1.71 [1.71 - 1.72] 米；P<0.0001）。调整身高后消除了收缩压的性别差异（未调整时为6.4 mmHg [5.0 - 7.9]，调整身高后为 -0.6 mmHg [-3.1 - 1.9]），而调整社会生物学变量后未消除（5.0 mmHg [3.4 - 6.6]）。女性高血压控制在<140/<90 mmHg的频率低于男性（38.0% [35.2 - 40.7] 对 47.1% [43.7 - 50.5]；P<0.001）。调整身高后消除了女性比男性高血压控制的较低比值比（未调整时为0.69 [0.60 - 0.79]）（调整后为1.12 [0.91 - 1.36]），但调整社会生物学变量后未消除（0.73 [0.63 - 0.85]）。
老年女性比男性身材矮小与收缩压较高和高血压控制较差有关。
