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Sex and gender in hypertension guidelines

This paper reviews 11 current and previous international and some selected national hypertension guidelines regarding sex and gender-related differences. Those differences can be attributed to biological sex and to gender differences that are determined by socially constructed norms. All reviewed gu...

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Detalles Bibliográficos
Autores principales: Meinert, Fabian, Thomopoulos, Costas, Kreutz, Reinhold
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403347/
https://www.ncbi.nlm.nih.gov/pubmed/36627514
http://dx.doi.org/10.1038/s41371-022-00793-8
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author Meinert, Fabian
Thomopoulos, Costas
Kreutz, Reinhold
author_facet Meinert, Fabian
Thomopoulos, Costas
Kreutz, Reinhold
author_sort Meinert, Fabian
collection PubMed
description This paper reviews 11 current and previous international and some selected national hypertension guidelines regarding sex and gender-related differences. Those differences can be attributed to biological sex and to gender differences that are determined by socially constructed norms. All reviewed guidelines agree on a higher hypertension prevalence in men than in women. They also concur that evidence does not support different blood pressure thresholds and targets for treatment between men and women. Differences refer in addition to the differences in epidemiological aspects to differences in some morphometric diagnostic indices, e.g., left ventricular mass or the limits for daily alcohol intake. Concerning practical management, there are hardly any clear statements on different procedures that go beyond the consensus that blockers of the renin–angiotensin system should not be used in women of childbearing age wishing to become pregnant. Some further sex-specific aspects are related to differences in tolerability or drug-specific side effects of BP-lowering drugs. There is also a consensus about the need for blood pressure monitoring before and during the use of contraceptive pills. For management of pregnancy, several guidelines still recommend no active treatment in pregnant women without severe forms of hypertension, despite a wide consensus about the definition of hypertension in pregnancy. A disparity in treatment targets when treating severe and non-severe hypertension in pregnancy is also observed. Overall, sex-specific aspects are only very sparsely considered or documented in the evaluated guidelines highlighting an unmet need for future clinical research on this topic.
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spelling pubmed-104033472023-08-06 Sex and gender in hypertension guidelines Meinert, Fabian Thomopoulos, Costas Kreutz, Reinhold J Hum Hypertens Review Article This paper reviews 11 current and previous international and some selected national hypertension guidelines regarding sex and gender-related differences. Those differences can be attributed to biological sex and to gender differences that are determined by socially constructed norms. All reviewed guidelines agree on a higher hypertension prevalence in men than in women. They also concur that evidence does not support different blood pressure thresholds and targets for treatment between men and women. Differences refer in addition to the differences in epidemiological aspects to differences in some morphometric diagnostic indices, e.g., left ventricular mass or the limits for daily alcohol intake. Concerning practical management, there are hardly any clear statements on different procedures that go beyond the consensus that blockers of the renin–angiotensin system should not be used in women of childbearing age wishing to become pregnant. Some further sex-specific aspects are related to differences in tolerability or drug-specific side effects of BP-lowering drugs. There is also a consensus about the need for blood pressure monitoring before and during the use of contraceptive pills. For management of pregnancy, several guidelines still recommend no active treatment in pregnant women without severe forms of hypertension, despite a wide consensus about the definition of hypertension in pregnancy. A disparity in treatment targets when treating severe and non-severe hypertension in pregnancy is also observed. Overall, sex-specific aspects are only very sparsely considered or documented in the evaluated guidelines highlighting an unmet need for future clinical research on this topic. Nature Publishing Group UK 2023-01-10 2023 /pmc/articles/PMC10403347/ /pubmed/36627514 http://dx.doi.org/10.1038/s41371-022-00793-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Meinert, Fabian
Thomopoulos, Costas
Kreutz, Reinhold
Sex and gender in hypertension guidelines
title Sex and gender in hypertension guidelines
title_full Sex and gender in hypertension guidelines
title_fullStr Sex and gender in hypertension guidelines
title_full_unstemmed Sex and gender in hypertension guidelines
title_short Sex and gender in hypertension guidelines
title_sort sex and gender in hypertension guidelines
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403347/
https://www.ncbi.nlm.nih.gov/pubmed/36627514
http://dx.doi.org/10.1038/s41371-022-00793-8
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