Sex Differences of Patients With Systemic Hypertension (From the Analysis of the Systolic Blood Pressure Intervention Trial [SPRINT])

Ochoa-Jimenez, Roberto Carlos; Viquez-Beita, Karolina; Daluwatte, Chathuri; Zusterzeel, Robbert

doi:10.1016/j.amjcard.2018.05.046

Cited by 18 publications

(10 citation statements)

References 24 publications

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“…Our results clearly showed that male subjects were at a greater risk of MACE than female subjects, and this difference between sexes tended to be greater at a younger age. Our results also can be supported by a recent post-hoc analysis of SPRINT 25 . After sex-specific propensity score-matched analysis between intensive and standard BP control, the aforementioned study reported that intensive BP control was effective in lowering CVD risk in men (HR, 0.70; 95% CI 0.57–0.86) but not in women (HR, 0.82; 95% CI 0.60–1.12).…”

Section: Discussionsupporting

confidence: 87%

Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

Kim

Lee

et al. 2020

Sci Rep

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The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15–1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32–1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex.

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Section: Discussionsupporting

confidence: 87%

Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

Kim

Lee

et al. 2020

Sci Rep

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“…However, a subsequent SPRINT post hoc sex-specific analysis has been undertaken utilising patient-level data [ 46 ]. In SPRINT, randomisation was not stratified according to sex; therefore, propensity score matching was applied to balance baseline characteristics between intensive versus standard treatment groups in both males and females.…”

Section: Sex-specific Hypertension Managementmentioning

confidence: 99%

Sex Differences in the Prevalence, Outcomes and Management of Hypertension

2022

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Purpose of Review To review recent data on sex differences in the prevalence, outcomes and management of hypertension. Recent Findings Although hypertension is overall more common in males, females experience a much sharper incline in blood pressure from the third decade of life and consequently the prevalence of hypertension accelerates comparatively with age. Mechanisms responsible for these blood pressure trajectories may include the sustained vascular influence of hypertensive disorders of pregnancy, interactions between the renin–angiotensin–aldosterone system and sex hormones or even psychosocial gendered factors such as socioeconomic deprivation. Moreover, the impact of hypertension is not uniform and females are at higher risk of developing a multitude of adverse cardiovascular outcomes at lower blood pressure thresholds. Summary Blood pressure is a sexually dimorphic trait and although significant differences exist in the prevalence, pathophysiology and outcomes of hypertension in males and females, limited data exist to support sex-specific blood pressure targets.

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“…In a separate study by Ochoa-Jimene et al, the patient-level data from SPRINT were analyzed to determine whether BP treatment effects differed by gender in participants less than 60 or over 60 26 in propensity score-matched populations. To account for the difference in baseline CV risk among men and women in SPRINT, propensity score matching was used to take into account this potentially confounding variable that can bias an outcome to control for baseline differences.…”

Section: Hypertension From Her Point Of Viewmentioning

confidence: 99%

Sex Differences in Hypertension: Where We Have Been and Where We Are Going

Ramirez

Sullivan

2018

American Journal of Hypertension

166

109

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As a result, the well-established gender difference in the prevalence of hypertension is even more pronounced and now extends into the sixth decade of life. The goals of this review are to (i) review the historical clinical trial data and hypertension guidelines from the perspective of both genders and then (ii) review the role of the renin-angiotensin system and T-cell activation in contributing to sex differences in BP control.

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Sex Differences of Patients With Systemic Hypertension (From the Analysis of the Systolic Blood Pressure Intervention Trial [SPRINT])

Cited by 18 publications

References 24 publications

Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients

Sex Differences in the Prevalence, Outcomes and Management of Hypertension

Sex Differences in Hypertension: Where We Have Been and Where We Are Going

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