Arterial hypertension in the female world: pathophysiology and therapy

被引:36
|
作者
Cadeddu, Christian [1 ]
Franconi, Flavia [2 ]
Cassisa, Laura [3 ]
Campesi, Ilaria [4 ,5 ]
Pepe, Alessia [6 ]
Cugusi, Lucia [1 ]
Maffei, Silvia [7 ,8 ]
Gallina, Sabina [9 ]
Sciomer, Susanna [10 ]
Mercuro, Giuseppe [1 ]
机构
[1] Univ Cagliari, Dept Med Sci M Aresu, Cagliari, Italy
[2] Univ Sassari, Dept Biomed Sci, Cagliari, Italy
[3] ASL Cagliari Marino ASL, Marino Hosp, Cardiol Complex Unit, Cagliari, Italy
[4] Univ Sassari, Dept Biomed Sci, Sassari, Italy
[5] Natl Inst Biostruct & Biosyst, Natl Lab Gender Med, Sassari, Italy
[6] Fdn G Monasterio CNR Reg Toscana, CMR Unit, Rome, Italy
[7] Fdn G Monasterio CNR Reg Toscana, Pisa, Italy
[8] CNR, Inst Clin Physiol, Via Savi 8, I-56100 Pisa, Italy
[9] Univ G dAnnunzio, Dept Neurosci Imaging & Clin Sci, Pescara, Italy
[10] Univ Roma La Sapienza, Dept Cardiovasc & Resp Sci, Rome, Italy
关键词
arterial hypertension; cardiovascular therapy; gender medicine; CONVERTING-ENZYME-INHIBITORS; BLOOD-PRESSURE CONTROL; GENDER-DIFFERENCES; SEXUAL FUNCTION; ANTIHYPERTENSIVE DRUGS; SYSTOLIC HYPERTENSION; POSTMENOPAUSAL WOMEN; LOWERING TREATMENT; HORMONAL-THERAPY; BETA-BLOCKERS;
D O I
10.2459/JCM.0000000000000315
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hypertension is a major risk factor for cardiovascular disease and outcomes in women, and antihypertensive therapy is not always successful in achieving control over the blood pressure (BP). Nonoptimal control of BP remains a crucial risk factor for cardiovascular mortality, and in women, it could be related to sex-specific factors. Historically, women have been under-represented in clinical trials; therefore, the benefits of clinical outcomes and the safety profiles of antihypertensive therapies have been studied less extensively in women. The reasons for the sex differences in BP levels are multifactorial, implying different roles of the sex hormones, the renin-angiotensin system, sympathetic activity, and arterial stiffness. A complete understanding of the pathophysiological features of these differences requires further investigation.Nevertheless, the prevalence of the use of antihypertensive agents is higher among middle-aged women than among men. Notably, in the United States, hypertensive women use more diuretics and angiotensin receptor blockers than men, whereas hypertensive men more often receive beta-blockers, calcium channel antagonists, or inhibitors of angiotensin-converting enzyme. To date, the explanations for these sex differences in the consumption of antihypertensive drugs remain unknown.
引用
收藏
页码:229 / 236
页数:8
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