The Pathophysiology, Prognosis and Treatment of Hypertension in Females from Pregnancy to Post-menopause: A Review.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Current Heart Failure Reports Pub Date : 2024-08-01 Epub Date: 2024-06-11 DOI:10.1007/s11897-024-00672-y
Simeng Li, Isabella Tan, Emily Atkins, Aletta E Schutte, Sonali R Gnanenthiran
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引用次数: 0

Abstract

Purpose of review: We summarise the physiological changes and risk factors for hypertension in females, potential sex-specific management approaches, and long-term prognosis.

Key findings: Pregnancy and menopause are two key phases of the life cycle where females undergo significant biological and physical changes, making them more prone to developing hypertension. Gestational hypertension occurs from changes in maternal cardiac output, kidney function, metabolism, or placental vasculature, with one in ten experiencing pregnancy complications such as intrauterine growth restriction and delivery complications such as premature birth. Post-menopausal hypertension occurs as the protective effects of oestrogen are reduced and the sympathetic nervous system becomes over-activated with ageing. Increasing evidence suggests that post-menopausal females with high blood pressure (BP) experience greater risk of cardiovascular events at lower BP thresholds, and greater vulnerability to treatment-related adverse effects. Hypertension is a key risk factor for cardiovascular disease in females. Current BP treatment guidelines and recommendations are similar for both sexes, without addressing sex-specific factors. Future investigations into ideal diagnostic thresholds, BP control targets and treatment regimens in females are needed.

从妊娠到绝经后女性高血压的病理生理学、预后和治疗:综述。
综述的目的:我们总结了女性高血压的生理变化和风险因素、潜在的性别特异性管理方法以及长期预后:妊娠和更年期是女性生命周期中的两个关键阶段,在这两个阶段中,女性的生理和体质会发生重大变化,从而更容易患上高血压。妊娠期高血压是由母体心输出量、肾功能、新陈代谢或胎盘血管的变化引起的,每十个人中就有一人出现妊娠并发症,如宫内生长受限和分娩并发症,如早产。绝经后高血压的发生是由于雌激素的保护作用减弱,交感神经系统随着年龄的增长而过度激活。越来越多的证据表明,绝经后女性高血压患者在较低的血压阈值下发生心血管事件的风险更大,也更容易受到与治疗相关的不良反应的影响。高血压是女性罹患心血管疾病的主要风险因素。目前针对男女两性的血压治疗指南和建议相似,但没有考虑到性别特异性因素。未来需要对女性的理想诊断阈值、血压控制目标和治疗方案进行研究。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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