Hypertension in women

Abstract

Hypertension in women has received little attention in comparison to men. There are only a handful of studies focusing on women with hypertension. Nevertheless, the data provide some information on the prevalence of hypertension in women, complications and the effectiveness of treatment. The Framingham Study showed that blood pressure (BP) increased with age in both men and women. The Hypertension Detection and Follow-up Program study demonstrated that hypertension was much more prevalent in men than women. However, in the postmenopausal group more than half were hypertensive. High BP is prevalent in older women. In absolute values, the complication rate is lower in women than in men but increases with age. At all levels of BP, the morbidity and mortality associated with BP is lower in women than men. Nevertheless, there is a five- to sixfold increase in risk in hypertensive compared with normotensive women. Furthermore, hypertensive women with a myocardial infarction have a worse prognosis than men. No study data using newer agents such as calcium channel blockers and angiotensin-converting enzyme inhibitors are available yet. Since antihypertensive treatment appears to be effective in smokers, cessation of smoking is a very important intervention. Studies such as the European Working Party on Hypertension in Elderly, Systolic Hypertension in Elderly, Swedish Trial of Old Patients with Hypertension, and Medical Research Council 1992 have recruited patients 60 years of age and older, mainly women. These trials have shown that in the elderly hypertensive all-cause mortality is reduced by 30%, stroke by 33%, congestive heart disease mortality by 20% and heart failure by 40% to 50% with treatment. However, even these newer trials have used the so-called "old medications'. Studies using "newer drugs' are in progress.