Impact of gender on 24-h ambulatory blood pressure and target organ damage

Abstract

Differences between male and female subjects in mean 24 h blood pressure (BP) values and target organ damage such as left ventricular mass (LVMASS) and intima-media thickness (IMT) of carotid arteries were explained. The study population consisted of 1445 subjects. All subjects underwent 24 h ambulatory BP monitoring, left ventricular echocardiography and measurement of IMT of carotid arteries. Men and women did not differ in age, body mass index (BMI) and clinic BP values. Mean 24 h systolic and diastolic BP were significantly higher in men compared to women. LVMASS corrected for body surface area or height 2.7 , IMT of common (MCCA) and internal (MICA) carotid arteries were found to be significantly higher in men compared to women. Analysis of covariance showed that men had significantly higher LVMASS, MCCA and MICA than women, after adjustment for BMI, age, smoking status, mean 24 h systolic and diastolic BPs, fasting serum glucose, total cholesterol and triglycerides. These findings indicate that male sex could be an important predictor of higher mean 24 h BP and target organ damage for subjects of similar BMI and clinic BP values.

Efficacy and safety of olmesartan medoxomil plus amlodipine in age, gender and hypertension severity defined subgroups of hypertensive patients

“…[15][16][17] One of the studies that established the efficacy of the olmesartan/amlodipine combination used a nonresponder design. Patients who failed to achieve an adequate level of BP control after 8 weeks' treatment with amlodipine (5 mg per day) were randomized to 8 weeks of treatment with one of three dose combinations of olmesartan (10,20 or 40 mg per day) plus amlodipine (5 mg per day), or to continue with amlodipine (5 mg) monotherapy. The study also included a further 8-week period of double-blind treatment, in which patients with suboptimal BP control had their treatment uptitrated.…”

“…The study also provides an opportunity to ascertain whether the combination is effective in specific patient groups. For example, certain BP-lowering treatment regimens have been reported to differ between men and women, [18][19][20] whereas others have shown no evidence of a gender difference. 21 Also, BP is known to increase with advancing age and it is important to determine that antihypertensive therapies are effective in older patients.…”

Detecting white coat and reverse white coat effects in clinic settings using measures of blood pressure habituation in the clinic and patient self-monitoring of blood pressure

“…In fact, recent research has confirmed that male sex was associated with higher ambulatory BPs and associated target organ pathology in contrast to a group of female patients matched on age, body mass index (BMI), smoking and cholesterol status and clinic BP. 26 It is well established that obesity is linked to high BP, 1 regardless of whether it is measured in the clinic or via ambulatory monitoring. Obesity has also been recently linked with an increased incidence of WCEs, but a decreased incidence of RWCEs.…”

“…However, because the univariate correlation coefficients for detecting WCE from home BP monitoring were so small, it seems highly unlikely that patient self-monitoring would contribute to its prediction even with a substantially larger sample. Research examining the relation between several demographic variables, like sex, obesity and smoking status, have typically employed much larger samples 26,27 than the sample used in the present study. It is quite likely that our sample size limited us in making comparisons with these previous studies using larger sample sizes.…”

Serum uric acid, the endothelium and hypertension: an association revisited

“…4 Non-dipping hypertension is associated with a higher risk of stroke, congestive heart failure, renal insufficiency, obstructive sleep apnoea and lower socioeconomic class. [5][6][7][8] Urate has been shown to be a powerful risk marker for all-cause mortality in untreated subjects with essential hypertension, 9 and is known to be an independent predictor of poor outcome and future vascular events in acute stroke. 10 Since both increased urate and hypertension (either office or ambulatory) are associated with the same disease processes, it would be expected that the two would tend to be associated with each other.…”