What is the clinical evidence from this study?

Study design: Review. Population: Essential hypertension. Intervention: Antihypertensive therapy.

What question did this study set out to answer?

Evaluate sex-specific differences in the epidemiology, pathology, clinical outcomes, and therapeutic responses associated with essential hypertension in women.

March 1, 1998Journal of women's health

Cardiovascular Disease in Women: Gender-Specific Aspects of Hypertension and the Consequences of Treatment

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Key result

Treatment of essential hypertension must be individualized by gender, as women may tolerate hypertension better than men and have unique considerations regarding oral contraceptives and estrogen.

Why the study?

Does gender affect the epidemiology, clinical course, and response to treatment in essential hypertension?

Population

Women with essential hypertension

Comparison

Antihypertensive drug therapy, oral… vs Men with hypertension, or black women

Design

Review

Authors

MLMarianne J. LegatoJohns Hopkins University

Discussion

Member takes

Implication

May support gender-specific hypertension considerations; leaves open need for prospective trials before practice change.

Key Points

Evaluate sex-specific differences in the epidemiology, pathology, clinical outcomes, and therapeutic responses associated with essential hypertension in women.
Reviewed clinical trial evidence and physiological mechanisms regarding sex differences in hypertension prevalence, progression, and mortality risks.
Analyzed the effects of hormonal influences, including oral contraceptives and postmenopausal estrogen replacement therapy, on blood pressure regulation.
Diastolic hypertension correlates with higher coronary artery disease mortality in men than in women, though contemporary drug therapies provide beneficial outcomes across both sexes.
Oral contraceptive use can precipitate or accentuate hypertension, whereas postmenopausal estrogen replacement may improve blood pressure by modulating vasomotricity, enhancing baroreceptor sensitivity, and mitigating hyperinsulinemia.
Early clinical trials demonstrated increased all-cause mortality in treated white women compared with black women or men, emphasizing the importance of gender-specific management strategies.

Structured PICO

Does gender affect the epidemiology, clinical course, and response to treatment in essential hypertension?

Population

Women with essential hypertension

Intervention

Antihypertensive drug therapy, oral contraceptives, and estrogen replacement therapy

Comparator

Men with hypertension, or black women (in early trials)

Outcome

All-cause mortality and coronary artery disease mortality

Treatment of hypertension must be individualized with respect to gender, taking into account specific factors such as oral contraceptive use and menopause.

Limitations

More data on the consequences of treatment of women with hypertension are needed, particularly longterm studies to assess the impact of treatment on mortality.
Lack of long-term studies assessing the impact of treatment on mortality in women

Cite This Study

Marianne J. Legato (1998) conducted a review in Essential hypertension. Antihypertensive therapy was evaluated. Treatment of essential hypertension must be individualized by gender, as women may tolerate hypertension better than men and have unique considerations regarding oral contraceptives and estrogen.

synapsesocial.com/papers/6a0eb72c7046b28dbef9a0b5 https://doi.org/10.1089/jwh.1998.7.199

Topics

Hypertension management Women and heart disease

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Cardiovascular Disease in Women: Gender-Specific Aspects of Hypertension and the Consequences of Treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Cardiovascular Disease in Women: Gender-Specific Aspects of Hypertension and the Consequences of Treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider