Hypertension in Women: A South-Asian Perspective

Abstract

IntroductionHypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women.Materials and MethodsNumerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women.ResultsThe pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the development of hypertension in women, including age, combined oral contraceptives (COCs), polycystic ovarian syndrome (PCOS), preeclampsia, etc. There are several sex specific considerations in antihypertensives drug choices.DiscussionDespite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in women. Medical treatment and adherence is uniquely challenging for South Asian women due to a variety of socio-cultural-economic factors. Further research is warranted to identify optimal sex-specific treatment options that will improve the control of hypertension and decrease the risk of subsequent cardiovascular disease in both genders.

InSH Consensus Guideline for the Management of Hypertension, 2023

“…[270][271][272][273][274] Analysis of data from the National Family Health Survey 4, Study of Ageing and Health Wave 2 datasets (NFHS-SAGE), and the Longitudinal Ageing Study of India (LASI) dataset revealed a distinct trend: males demonstrated a higher prevalence of hypertension until the age of 50, after which females exhibited higher rates. 275 Based on the WHO-SAGE study, hypertension was more prevalent in tribals, poor, Sikhs, and older women. 276 Child brides and adolescent mothers have been reported to be more likely to have hypertension later in life.…”

Hyperuricemia and Endothelial Function: Is It a Simple Association or Do Gender Differences Play a Role in This Binomial?

“…Male individuals develop cardiovascular diseases attributable to endothelial dysfunction earlier and more frequently than women. This difference between the two sexes persists until menopause, when endothelial dysfunction has a slightly higher incidence in women than in men [ 34 , 35 ]. The decline in female sex hormones, especially estrogen, and the negative effect of androgens are the factors that underlie the loss of the protection enjoyed by women of childbearing age.…”