Hypertension in females
Authors:
Renata Cífková 1,2
Authors‘ workplace:
Centrum kardiovaskulární prevence 1. LF UK a Thomayerovy nemocnice Praha, vedoucí prof. MUDr. Renata Cífková, CSc.
1; II. interní klinika – klinika angiologie a kardiologie 1. LF UK a VFN, Praha, přednosta prof. MUDr. Aleš Linhart, DrSc., FESC, FCMA
2
Published in:
Prakt Gyn 2015; 19(4): 224-229
Category:
Gynecology and Obstetrics: Review Article
Overview
Hypertension is the most common cardiovascular disorder affecting more males in younger age groups; in the age group of 45–64, it is equally frequent in both genders, it is more common in elderly females. Blood pressure increases more in females around the menopause. Use of hormonal replacement therapy is not associated with an BP increase but, because of increased risk of coronary events, stroke, and thromboembolic events, HRT is not recommended in CVD prevention. There is a similar decrease in BP by antihypertensive drugs in both genders as well as benefit from antihypertensive treatment. Women report about a double rate of adverse events of antihypertensive drugs. Oral contraception use is associated with a mild BP increase in most women and development of overt hypertension in about 5 %. Pre-eclampsia is associated with increased risk of developing CVD later in life (more frequent development of hypertension, myocardial infarction, and stroke).
Key words:
epidemiology of hypertension – gestational hypertension – hormonal replacement therapy – hypertension in pregnancy – oral contraception – pre-eclampsia – randomized clinical trials in hypertension
Sources
1. Zdravotnická ročenka České republiky 2013. ÚZIS ČR: Praha 2014. ISBN 978–80–7472–135–9.
2. Go AS, Mozaffarian D, Roger VL et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation 2013; 127(1): e6-e245. Dostupné z DOI: <http://doi:10.1161/CIR.0b013e31828124ad>.
3. Go AS, Mozaffarian D, Roger VL et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2014 update: a report from the American Heart Association. Circulation 2014; 129(3): e28-e292. Dostupné z DOI: <http://doi: 10.1161/01.cir.0000441139.02102.80>.
4. Report of the Second Task Force on Blood Pressure Control in Children – 1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987; 79(1): 1–25.
5. Primatesta P, Brookes M, Poulter NR. Improved hypertension management and control. Results from the Health Survey for England 1998. Hypertension 2001; 38(4): 827–832.
6. Coylewright M, Reckelhoff JF, Ouyang P. Menopause and hypertension: an age-old debate. Hypertension 2008; 51(4): 952–959.
7. Cífková R, Bruthans J, Adámková V et al. Prevalence základních kardiovaskulárních rizikových faktorů v české populaci v letech 2006–2009. Studie Czech post-MONICA. Cor Vasa 2011; 53(4–5): 220–229.
8. Keyhani S, Scobie JV, Hebert PL et al. Gender disparities in blood pressure control and cardiovascular care in a national sample of ambulatory care visits. Hypertension 2008; 51(4): 1149–1155.
9. Gu Q, Burt VL, Paulose-Ram R et al. Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999–2004. Am J Hypertens 2008; 21(7): 789–798.
10. Olsen H, Klemetsrud T, Stokke HP et al. Adverse drug reactions in current antihypertensive therapy: a general practice survey of 2586 patients in Norway. Blood Press 1999; 8(2): 94–101.
11. Wassertheil-Smoller S, Anderson G, Psaty BM et al. Hypertension and its treatment in postmenopausal women: baseline data from the Women’s Health Initiative. Hypertension 2000; 36(5): 780–789.
12. Oparil S. Women and hypertension: what did we learn from the Women’s Health Initiative? Cardiol Rev 2006; 14(6): 267–275.
13. Journath G, Hellénius ML, Manhem K. Hyper-Q Study Group, Sweden. Association of physician’s sex with risk factor control in treated hypertensive patients from Swedish primary healthcare. J Hypertens 2008; 26(10): 2050–2056.
14. Laughlin GA, Barret-Connor E, Kritz-Silverstein D et al. Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study. J Clin Endocrinol Metab 2000; 85(2): 645–651.
15. Reckelhoff JF, Fortepiani LA. Novel mechanisms responsible for postmenopausal hypertension. Hypertension 2004; 43(5): 918–923.
16. The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 1995; 273(3): 199–208.
17. Grodstein F, Manson JE, Stampfer MJ. Postmenopausal hormone use and secondary prevention of coronary events in the nurses’ health study; a prospective, observational study. Ann Intern Med 2001; 135(1): 1–8.
18. Falkenborn M, Persson I, Terent A et al. Hormone replacement therapy and the risk of stroke, follow-up of a population-based cohort in Sweden. Arch Intern Med 1993; 153(10): 1201–1209.
19. Finucane FF, Madans JH, Bush TL et al. Decreased risk of stroke among postmenopausal hormone users, results from a national cohort. Arch Intern Med 1993; 153(1): 73–79.
20. Scuteri A, Bos AJG, Brant LJ et al. Hormone replacement therapy and longitudinal changes in blood pressure in postmenopausal women. Ann Intern Med 2001; 135(4): 229–238.
21. Hulley S, Grady D, Bush T et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 1998; 280(7): 605–613.
22. Rossouw JE, Anderson GL, Prentice RL et al. Writing Group of Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002; 288(3): 321–333.
23. Farquhar CM, Marjoribanks J, Lethaby A et al. Cochrane HT Study Group. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev 2005; (3):CD004143. Dostupné z DOI: <http://dx.doi.org/10.1002/1465868.CD004143.pub2>.
24. Mosca L, Benjamin EJ, Berra K et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women – 2011 update: a guideline from the American Heart Association. Circulation 2011; 123(11): 1243–1262. Erratum in Circulation. 2011; 123(22): e624. Circulation. 2011; 124(16): e427.
25. Melloni C, Berger JS, Wang TY et al. Representation of women in randomized clinical trials of cardiovascular disease prevention. Circ Cardiovasc Qual Outcomes 2010; 3(2): 135–142.
26. Turnbull F, Woodward M, Neal B et al. Blood Pressure Lowering Treatment Trialists’ Collaboration. Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials. Eur Heart J 2008; 29(21): 2669–2680.
27. Gueyffier F, Boutitie F, Boissel JP et al. The INDANA Investigators. The effect of antihypertensive drug treatment on cardiovascular outcomes in women and men. Results from a meta-analysis of individual patient data randomised controlled trials. Ann Inter Med 1997; 126(10): 761–767.
28. Wing LM, Reid CM, Ryan P et al. Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med 2003; 348(7): 583–592.
29. Zanchetti A, Julius S, Kjeldsen S et al. Outcomes in subgroups of hypertensive patients treated with regimens based on valsartan and amlodipine: An analysis of findings from the VALUE trial. J Hypertens 2006; 24(11): 2163–2168.
30. Klungel OH, De Boer A, Paes AHP et al. Sex differences in the pharmacological treatment of hypertension: a review of population-based studies. J Hypertens 1997; 15(6): 591–600.
31. Lewis CE. Characteristics and treatment of hypertension in women: a review of the literature. Am J Med Sci 1996; 311(4): 193–199.
32. Cauley JA, Cummings SR, Seeley DG et al. Effects of thiazide diuretic therapy on bone mass, fractures, and falls. The study of Osteoporotic Fractures Research Group. Ann Intern Med 1993; 118(9): 666–673.
33. Lewis CE, Grandits GA, Flack J et al. Efficacy and tolerance of antihypertensive treatment in men and women with stage 1 diastolic hypertension. Results of the Treatment of Mild Hypertension Study. Arch Intern Med 1996; 156(4): 377–385.
34. August P, Oparil S. Hypertension in women. J Clin Endocrinol Metab 1999; 84(6): 1862–1866.
35. Woods JW. Oral contraceptives and hypertension. Hypertension 1988; 11(3 Pt 2): II11-II15.
36. Dong W, Colhoun HM, Poulter NR. Blood pressure in women using oral contraceptives: results from the Health Survey for England 1994. J Hypertens 1997; 15(10): 1063–1068.
37. Ribstein J, Halimi JM, Du Cailar G et al. Renal characteristics and effect of angiotensin suppression in oral contraceptive users. Hypertension 1999; 33(1): 90–95.
38. Curtis KM, Mohlajee AP, Martins SL et al. Combined oral contraceptive use among women with hypertension: a systematic review. Contraception 2006; 73(2): 179–188.
39. Margolis KL, Adami HO, Luo J et al. A prospective study of oral contraceptive use and risk of myocardial infarction among Swedish women. Fertil Steril 2007; 88(2): 310–316.
40. Chakhtoura Z, Canonico M, Gompel A et al. Progestogen-only contraceptives and the risk of acute myocardial infarction: a meta-analysis. J Clin Endocrinol Metab 2011; 96(4): 1169–1174.
41. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy. Arch Intern Med 2004; 164(18): 1965–1976.
42. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception 2004; 69(2): 89–97.
43. Lidegaard O, Nielsen LH, Skovlund CW et al. Venous thrombosis in users of nonoral hormonal contraception: follow-up study, Denmark 2001–10. BMJ 2012; 344: e2990. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.e2990>.
44. World Health Organization. Medical eligibility criteria for contraceptive use. 3rd ed. World Health Organization: Geneva 2004. ISBN 92 4 156266 8.
45. Lubianca JN, Moreira LB, Gus M et al. Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension. J Hum Hypertens 2005; 19(6): 451–455.
46. ACOG Committee on practice bulletin–Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006; 107(6): 1453–1472.
47. Cífková R. Hypertenze v těhotenství. In: Widimský J Jr, Widimský J (eds). Hypertenze. 4th ed. Triton: Praha 2014: 416–434. ISBN 978–80–7387–811–5.
48. Paradisi G, Biaggi A, Savone R et al. Cardiovascular risk factors in healthy women with previous gestational hypertension. J Clin Endocrinol Metab 2006; 91(4): 1233–1238.
49. Rich-Edwards JW, Fraser A, Lawlor DA et al. Pregnancy characteristics and women’s future cardiovascular health: an underused opportunity to improve women’s health? Epidemiol Rev 2014; 36: 57–70.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Practical Gynecology
2015 Issue 4
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