Novel Advances in Our Understanding of Sex-Dependent Control of Blood Pressure

Sex differences in blood pressure are evident from puberty through menopause, with premenopausal females exhibiting lower blood pressure than males. This review discusses key factors contributing to sex differences in blood pressure, focusing on the normotensive state. Key contributions from a number of systems are discussed, including cardiovascular and renal function, oxidative stress, immune cell involvement, the microbiome, and the roles of the nervous system and renin-angiotensin-aldosterone system. Additionally, we highlight novel advances in the field, including findings related to the G protein–coupled estrogen receptor (GPER), Klotho, olfactory receptor 558 (OLFR558), and the four-core genotype (FCG) model. Insights from clinical data and their implications for hypertension management are also considered. In sum, this review aims to integrate current knowledge on sex differences in blood pressure regulation to inform future research and clinical care.