The impact of sex on blood pressure.

Abstract

Purpose of review: Hypertension is the most prevalent cardiovascular disease worldwide and the leading cause of mortality in both men and women. Despite well documented sex differences in prevalence, risk factors, and treatment responses, current guidelines still fail to take these specificities into account. A more tailored approach, accounting for sex-specific pathophysiological mechanisms and risk factors, is essential.

Recent findings: Studies show that hypertension is more prevalent in men than in women until menopause. After menopause, the prevalence increases in women, likely due to hormonal changes. Additionally, genetic, metabolic, and social risk factors differ between the sexes, as do cardiovascular risks and associated comorbidities. Pharmacokinetic and pharmacodynamic variations also impact antihypertensive treatment efficacy and side effects, highlighting the need for a more individualized therapeutic strategy. This review explores the pathophysiology of hypertension by sex, global risk factors with a focus on female-specific aspects, and sex-related cardiovascular risks. We also discuss antihypertensive treatments and their effectiveness based on gender-specific characteristics.

Summary: Incorporating sex differences into hypertension management could enhance treatment efficacy and reduce cardiovascular mortality. Further research is needed to refine guidelines and develop personalized therapeutic strategies, optimizing hypertension care and improving patient outcomes.