Sex differences in arterial hypertension A scientific statement from the ESC Council on Hypertension, the European Association of Preventive Cardiology, Association of Cardiovascular Nursing and Allied Professions, the ESC Council for Cardiology Practice, and the ESC Working Group on Cardiovascular Pharmacotherapy

Gerdts, Eva; Sudano, Isabella; Brouwers, Sofie; Borghi, Claudio; Bruno, Rosa Maria; Ceconi, Claudio; Cornelissen, Veronique; Dievart, Francois; Ferrini, Marc; Kahan, Thomas; Lochen, Maja Lisa; Maas, Angela HEM; Mahfoud, Felix; Mihailidou, Anastasia S; Moholdt, Trine; Parati, Gianfranco; de Simone, Giovanni

doi:10.1093/eurheartj/ehac470

Sex differences in arterial hypertension A scientific statement from the ESC Council on Hypertension, the European Association of Preventive Cardiology, Association of Cardiovascular Nursing and Allied Professions, the ESC Council for Cardiology Practice, and the ESC Working Group on Cardiovascular Pharmacotherapy

Author:

Gerdts, Eva

Sudano, Isabella ; Brouwers, Sofie ; Borghi, Claudio ; Bruno, Rosa Maria ; Ceconi, Claudio ; Cornelissen, Veronique ; Dievart, Francois ; Ferrini, Marc ; Kahan, Thomas ; Lochen, Maja Lisa ; Maas, Angela HEM ; Mahfoud, Felix ; Mihailidou, Anastasia S ; Moholdt, Trine ; Parati, Gianfranco ; de Simone, Giovanni

Keywords:

Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Hypertension, Sex, Blood Pressure regulators, Hypertension-mediated organ damage, Pharmacological treatment, Adverse events, Cardiovascular disease, Sex hormones, LEFT-VENTRICULAR HYPERTROPHY, END-POINT REDUCTION, PULSE-WAVE VELOCITY, DISEASE RISK-FACTORS, LEFT ATRIAL SIZE, BLOOD-PRESSURE, GENDER-DIFFERENCES, ANTIHYPERTENSIVE TREATMENT, LOSARTAN INTERVENTION, CONSENSUS DOCUMENT, Female, Humans, Male, Sex Characteristics, RISK-FACTORS, 1102 Cardiorespiratory Medicine and Haematology, 1103 Clinical Sciences, Cardiovascular System & Hematology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences

Abstract:

There is strong evidence that sex chromosomes and sex hormones influence blood pressure (BP) regulation, distribution of cardiovascular (CV) risk factors and co-morbidities differentially in females and males with essential arterial hypertension. The risk for CV disease increases at a lower BP level in females than in males, suggesting that sex-specific thresholds for diagnosis of hypertension may be reasonable. However, due to paucity of data, in particularly from specifically designed clinical trials, it is not yet known whether hypertension should be differently managed in females and males, including treatment goals and choice and dosages of antihypertensive drugs. Accordingly, this consensus document was conceived to provide a comprehensive overview of current knowledge on sex differences in essential hypertension including BP development over the life course, development of hypertension, pathophysiologic mechanisms regulating BP, interaction of BP with CV risk factors and co-morbidities, hypertension-mediated organ damage in the heart and the arteries, impact on incident CV disease, and differences in the effect of antihypertensive treatment. The consensus document also highlights areas where focused research is needed to advance sex-specific prevention and management of hypertension.