What are the sex differences in hypertension and BP regulation?
Sex differences in hypertension and BP regulation are complex, because ovarian hormones influence BP considerably. Notably, hypertensive women are significantly more likely to be treated than men but less likely to have achieved BP control. This may be because of unknown physiological mechanisms (ie, arterial stiffness, overactivation of the renin- angiotensin system) or poorer compliance in women. Data from the Framingham Heart Study showed an age-related decrease in BP control rates that was more pronounced in women than men.112 Among participants >80 years of age with hypertension, only 23% of women (versus 38% of men) had BP <140/90 mmHg.112 In analyses from the NHANES III and IV cohorts, the age- adjusted prevalence of uncontrolled BP was 50.8 2.1% in men and 55.9 1.5% in women, which was not significantly different; women had a higher prevalence of other concomitant cardiovascular risk factors,110 which likely contributed to poorer BP control in elderly women.