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. 2011 May;29(5):1005-11.
doi: 10.1097/HJH.0b013e3283449512.

Age-dependent gender differences in hypertension management

Stacie L Daugherty  1 , Frederick A Masoudi, Jennifer L Ellis, P Michael Ho, Julie A Schmittdiel, Heather M Tavel, Joe V Selby, Patrick J O'Connor, Karen L Margolis, David J Magid
Affiliations

Age-dependent gender differences in hypertension management

Stacie L Daugherty et al. J Hypertens. 2011 May.

Abstract

Objective: Despite gender-neutral guidelines, prior studies suggest that women have lower rates of hypertension control and these differences may vary with age. Accordingly, we compared rates of hypertension control between women and men as a function of age.

Methods: Within three integrated healthcare systems in the Cardiovascular Research Network, we studied all patients seen from 2001 to 2007 with incident hypertension. Within 1 year of cohort entry, patient's hypertension was categorized as controlled based upon achieving guideline-recommended blood pressure levels, recognized if hypertension was diagnosed or a hypertension medication dispensed, and treated based on hypertension medications dispensed. Multivariable logistic regression models assessed the association between gender and 1-year hypertension outcomes, adjusted for patient characteristics.

Results: Among the 152,561 patients with incident hypertension, 55.6% were women. Compared to men, women were older, had more kidney disease and more blood pressure measures during follow-up. Overall, men tended to have lower rates of hypertension control compared to women (41.2 vs. 45.7%, adjusted odds ratio 0.93, 95% confidence interval 0.91-0.95). A significant gender by age interaction was found with men aged 18-49 having 17% lower odds of hypertension control and men aged at least 65 having 12% higher odds of hypertension control compared to women of similar ages (P<0.001).

Conclusion: In this incident hypertension cohort, younger men and older women had lower rates of hypertension control compared to similarly aged peers. Future studies should investigate why gender differences vary by age in order to plan appropriate means of improving hypertension management regardless of gender or age.

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Figures

Figure 1
Figure 1
Rates of HTN control in men compared to women. Adjusted models control for patient age, race, BP level at cohort entry, year of cohort entry, study site, number of BP measurements during the follow-up period and coexisting conditions.
Figure 2
Figure 2
Rates of HTN recognition and treatment in men compared to women stratified by age. Models control for patient age, race, BP level at cohort entry, year of cohort entry, study site, number of BP measurements during the follow-up period and coexisting conditions.
See this image and copyright information in PMC

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