Key result
Only half of major hypertension guidelines include sex- and gender-based guidance, predominantly focusing on pregnancy.
Why the study?
Hypertension causes one in five deaths of American women and sex- or gender-based differences exist in its epidemiology and management, but whether major society guidelines include sex- and gender-based language was unclear.
Major hypertension guidelines currently lack comprehensive guidance on sex- and gender-based differences outside of pregnancy.
Hypertension guidelines lack sex- and gender-specific recommendations beyond pregnancy; leaves open need for targeted research to inform future updates.
Background: Hypertension (HTN) accounts for one in five deaths of American women. Major societies worldwide aim to make evidence-based recommendations for HTN management. Sex- or gender-based differences exist in epidemiology and management of HTN; in this study, we aimed to assess sex- and gender-based language in major society guidelines. Materials and Methods: We reviewed HTN guidelines from four societies: the American College of Cardiology (ACC), the American College of Emergency Physicians (ACEP), the European Society of Cardiology (ESC), and the Eighth Joint National Committee (JNC8). We quantified the sex- and gender-based medicine (SGBM) content by word count in each guideline as well as identified the gender of guideline authors. Results: Two of the four HTN guidelines (ACC, ESC) included SGBM content. Of these two guidelines, there were variations in the quantity and depth of content coverage. Pregnancy had the highest word count found in both guidelines (422 words in ACC and 1,523 words in ESC), which represented 2.45% and 3.04% of the total words in each guideline, respectively. There was minimal coverage, if any, of any other life periods. The number of women authors did not impact the SGBM content within a given guideline. Conclusions: Current HTN management guidelines do not provide optimal guidance on sex- and gender-based differences. Inclusion of sex, gender identity, hormone therapy, pregnancy and lactation status, menopause, and advanced age in future research will be critical to bridge the current evidence gap. Guideline writing committees should include diverse perspectives, including cisgender and transgender persons from diverse racial and ethnic backgrounds.
No takes yet. Share an insight, caveat, or question.
Griffin et al. (2022) conducted a review in Hypertension (n=4). Sex- and gender-based medicine (SGBM) content analysis was evaluated on Sex- and gender-based medicine (SGBM) content by word count. Current hypertension management guidelines lack optimal guidance on sex- and gender-based differences, with only two of four major guidelines including such content, predominantly focused on pregnancy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: