Key result
Hypertensive women face elevated CV risk at lower BP levels and more side effects than men.
Why the study?
Hypertensive patients are often treated uniformly and guidelines propose identical targets and algorithms for both sexes, ignoring significant sex differences in hypertension pathophysiology, treatment response, and outcomes.
Are there sex-specific differences in the pathophysiology, treatment response, and outcomes of arterial hypertension in women compared to men?
Are there sex-specific differences in the pathophysiology, treatment response, and outcomes of arterial hypertension in women compared to men?
This review highlights the need to consider sex-specific differences in the pathophysiology and management of arterial hypertension, challenging current guidelines that propose uniform treatment for both sexes.
Supports sex-specific BP thresholds and therapy in women; leaves open guideline updates pending randomized confirmation.
Arterial hypertension is the most important modifiable cardiovascular risk factor and a major cause of cardiovascular mortality worldwide. In daily clinical practice, the hypertensive patient is often treated in a uniform way, thus ignoring the significant effects of sex on several aspects of hypertension, including its prevalence, pathophysiology, response to antihypertensive treatment, and outcomes. Along with the immune response and several cardiometabolic risk factors that frequently coexist, the substantial hormonal changes during a woman's life cycle are among the main pathophysiological mechanisms driving hypertension in women. Concurrently, women exhibit increased cardiovascular risk at lower blood pressure (BP) levels compared to age-matched men and present certain disparities in the incidence of cardiovascular events and subsequent hypertension-related cardiovascular prognosis. In addition, women respond differently to antihypertensive treatment, experience more drug-related side effects, and exhibit lower rates of BP control compared to men. Currently, international guidelines propose the same targets and the same therapeutic algorithms for the treatment of hypertension in both sexes without taking into account the sex differences that exist. In this review, we aim to describe certain particularities of arterial hypertension in the female sex, moving from pathophysiological aspects to clinical and therapeutical management.
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Lazaridis et al. (2025) conducted a review in Arterial hypertension. Women with arterial hypertension exhibit increased cardiovascular risk at lower blood pressure levels, respond differently to treatment, and experience more side effects compared to men.
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