VIEWS: 7 PAGES: 1 POSTED ON: 11/13/2011
Jeanette Strametz-Juranek Women`s high blood pressure: do we treat women properly? Hypertension is an important worldwide public-health challenge, the leading riskfaktor for cardiovascular and kidney diseases and ranked third as cause of disability- adjusted life-years in women and men. However, there are major genderspecific differences in prevalence, pathophysiology, awareness and treatment of hypertension. After menopause the incidence and prevalence of hypertension is markedly increasing in women. Before menopause endogenous estrogens seems to protect the endothelium, but after menopause, the continous decline of estrogens is a associtaed with a marked increase of vasoconstrictors such as Endothelin, Angiotensin, leading to subsequent stiffness and vasoconstriction in the endothelium. Further is comes to an activation of the symphatetic nerve activity, increased insulin resistance, weight gain and salt sensitivity all leading to hypertension in postmenopausal women. Also in treatment of hypertension are genderspecific differences. In a recent study in Sweden it has been shown that women are less treated with ACE-inhibitors/AT-II-receptor-blockers and receive more beta-blockres and diuretics. Furthermore, they received less statins to minimize their cardiovascular risk. In most hypertension guidlines „sex and gender“ are not included, so women and men right now have the same treatment goals in hypertension, not emphazining that the cardiovascular risk is markeldy increasing in postmenopausal women. In future more women have to be included in large clinical trials, focusing on the specific role of estrogens, estrogen receptors, salt sensitivity and optimal blood pressure target values in the female population to fight against the increasing hypertension-associated morbodity and mortality in women.
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