Sex differences in antihypertensive drug use and blood pressure control

Wang, Jun-Wen; Jiang, Weihong; Sharma, Manju; Wu, Yuyan; Li, Jiayin; You, Nana; Ding, Zewen; Zhao, Xiexiong; Chen, Huilin; Tang, Huiting; Zhou, Xiaoyu; Li, Yong

doi:10.1136/postgradmedj-2019-136513

Cited by 12 publications

(14 citation statements)

References 32 publications

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“…Wang et al reported that in patients aged 18-44 years, angiotensin-converting enzyme inhibitors showed the best control rate in males, while calcium channel blockers were least effective. Inpatients aged 45-64 years, diuretics showed the best control rate in females, while calcium channel blockers were least effective [24]. Klungel et al reported that the different patterns of antihypertensive drug use among hypertensive men and women seem irrational and that among those on monotherapy for hypertension, women were less likely than men to be using a β-blocker, a calcium antagonist, or an angiotensinconverting enzyme inhibitor than a diuretic [25].…”

Section: Resultsmentioning

confidence: 99%

Gender Differences in Prescribing Antihypertensive Drugs in a Public Hospital in Alkharj

Ahmed

Menshawy

Almalki

2020

JPRI

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Introduction: Hypertension is considered one of the most significant risk factors for mortality and morbidity worldwide. There are major clinical implications for gender-specific pharmacokinetics and pharmacodynamics. It is important to know the potential gender differences in hypertension treatment and to know the prescribing trends in male and female hypertensive patients in order to optimize the treatment of hypertension. Aim: This is a retrospective study that aims to describe the difference in prescribing antihypertensive drugs between male and female patients. Methodology: This is a retrospective study that includes the revision of patient electronic records of outpatients with hypertension in 2018 in Alkharj. Results: The total number of prescribed antihypertensive drugs was 1838 drugs. The calcium channel blocker was the most commonly prescribed antihypertensive class (27.86%). The study showed that there are different patterns of antihypertensive drug use among hypertensive men and women and showed that female patients are more frequently treated with diuretics and less frequently with angiotensin-converting enzyme inhibitors and angiotensin receptors blockers than male patients. Conclusion: Stratified guidelines and policies based on gender will be appropriate if more studies show a difference in the efficacy and safety of antihypertensive drugs between male and female patients. It is important to conduct more studies about these differences.

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Section: Resultsmentioning

confidence: 99%

Gender Differences in Prescribing Antihypertensive Drugs in a Public Hospital in Alkharj

Ahmed

Menshawy

Almalki

2020

JPRI

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“…Beyond the characteristics of the drug and the individual ( Table 2 ), which are extensively reviewed [ 38 , 47 , 48 ], the pharmacological response depends on other numerous factors and their interactions [ 49 ], which are summarized in Figure 1 . Sex and gender differences involve drug consumption [ 6 , 50 , 51 , 52 , 53 ] and adherence to therapy, which usually tends to be larger in men and women, respectively, with some exceptions [ 54 , 55 ].…”

Section: Factors That Can Affect the Pharmacological Responsementioning

confidence: 99%

The Person’s Care Requires a Sex and Gender Approach

Campesi

Montella

Seghieri³

et al. 2021

JCM

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There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex–gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.

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“…observed (1,(5)(6)(7)(8)(9)(10)(11)(12)(13). For example, sex differences in the Renin Angiotensin Aldosterone System, speci cally in androgen and estrogen receptor expression, have been observed in animals and humans (6,(8)(9)(10)(11)13).…”

Section: Introductionmentioning

confidence: 99%

“…For example, sex differences in the Renin Angiotensin Aldosterone System, speci cally in androgen and estrogen receptor expression, have been observed in animals and humans (6,(8)(9)(10)(11)13). Several studies have identi ed sex-speci c single nucleotide polymorphisms associated with HT and disparities between women and men in pharmacogenetic drug responses to available therapies (7,(14)(15)(16). Additionally, women generally have lower BP than men prior to the onset of menopause (16).…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Blood Pressure and the Kidney Cortex Transcriptome in Nonhuman Primates

Riojas¹,

Spradling-Reeves²,

Shade³

et al. 2021

Preprint

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Hypertension is a complex disease influenced by sex, and genetic and environmental factors. Blood pressure (BP) is a continuous trait that is heritable in primates, including humans and baboons. The kidneys play a role in systemically regulating BP. Sex differences in BP onset and control with antihypertensive drug therapies have been observed in humans and rodents. Hypertension studies in nonhuman primates (NHP) to date have focused on males. We hypothesized that there are differences in renal molecular networks associated with BP in female and male primates. Sodium-naïve female (n=8) and male (n=9) baboons were fed a low-sodium chow diet prior to and during the study. Implantable telemetry devices continuously monitored heart rate and blood pressure over 24-hours, and ultrasound-guided kidney biopsies were collected for RNA-Seq. Serum 17 beta-estradiol concentration correlated BP in females. BP in males correlated with Na+ intake, blood urea nitrogen, and glucose. Cell type composition of renal biopsies was consistent between females and males. Sex differences were observed in the kidney transcriptomes by principal components analysis and weighted gene co-expression network analysis. Network analysis revealed HNF4A, ESR1, ESR2, SMARCA4, TP53, and NR3C1 as BP regulators in males. Our results demonstrate sex differences in primate kidney molecular networks and provide evidence of a novel link between renal transcription factors and BP regulation in males. Understanding sex differences and transcriptome variation in primate kidneys correlated with BP and clinical measures associated with BP will inform better therapies towards the goal of precision medicine for women and men.

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Sex differences in antihypertensive drug use and blood pressure control

Cited by 12 publications

References 32 publications

Gender Differences in Prescribing Antihypertensive Drugs in a Public Hospital in Alkharj

Gender Differences in Prescribing Antihypertensive Drugs in a Public Hospital in Alkharj

The Person’s Care Requires a Sex and Gender Approach

Sex Differences in Blood Pressure and the Kidney Cortex Transcriptome in Nonhuman Primates

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