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Hypertension in Women Across the Lifespan

  • Women and Ischemic Heart Disease (J.M. Peña and F. Lin, Section Editors)
  • Published:
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Abstract

Purpose of Review

We will highlight the biological processes across a women’s lifespan from young adulthood through menopause and beyond that impact blood pressure and summarize women’s representation in hypertension clinical trials.

Recent Findings

Throughout their lifetime, women potentially undergo several unique sex-specific changes that may impact their risk of developing hypertension. Blood pressure diagnostic criteria for pregnant women remains 140/90 mmHg and has not been updated for concordance with the 2017 ACC/AHA guideline due to a lack of data. Although on a population level, women develop hypertension at later ages than men, new data shows women’s BP starts to increase as early as the third decade. Understanding how age and sex both contribute to hypertension in elderly women is crucial to identify optimal blood pressure and treatment targets.

Summary

Effective screening, monitoring, and treatment of hypertension throughout a women’s lifespan are necessary to reduce CVD risk. We highlight several gaps in the literature pertaining to understanding sex-specific hypertension mechanisms.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Collaborators GRF. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1923–94.

    Article  Google Scholar 

  2. Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134(6):441–50.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wei YC, George NI, Chang CW, Hicks KA. Assessing sex differences in the risk of cardiovascular disease and mortality per increment in systolic blood pressure: a systematic review and meta-analysis of follow-up studies in the United States. PLoS One. 2017;12(1):e0170218.

    Article  PubMed  PubMed Central  Google Scholar 

  4. ROBINSON SC, BRUCER M. Range of normal blood pressure: a statistical and clinical study of 11,383 persons. Arch Intern Med (Chic). 1939;64(3):409–44. https://doi.org/10.1001/archinte.1939.00190030002001.

    Article  Google Scholar 

  5. Syme C, Abrahamowicz M, Leonard GT, Perron M, Richer L, Veillette S, et al. Sex differences in blood pressure and its relationship to body composition and metabolism in adolescence. Arch Pediatr Adolesc Med. 2009;163(9):818–25.

    Article  PubMed  Google Scholar 

  6. Joyner MJ, Wallin BG, Charkoudian N. Sex differences and blood pressure regulation in humans. Exp Physiol. 2016;101(3):349–55.

    Article  PubMed  Google Scholar 

  7. •• Ji H, Kim A, Ebinger JE, Niiranen TJ, Claggett BL, Bairey Merz CN, et al. Sex Differences in Blood Pressure Trajectories Over the Life Course. JAMA Cardiol. 2020;5(3):19–26 Women have a steeper increase in blood pressure compared to men beginning as early as the third decade.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation. 2021;143:e254–743 CIR0000000000000950.

    Article  PubMed  Google Scholar 

  9. O'Neil A, Scovelle AJ, Milner AJ, Kavanagh A. Gender/sex as a social determinant of cardiovascular risk. Circulation. 2018;137(8):854–64.

    Article  PubMed  Google Scholar 

  10. Lauer RM, Clarke WR. Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics. 1989;84(4):633–41.

    Article  CAS  PubMed  Google Scholar 

  11. Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniels SR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics. 2007;119(2):237–46.

    Article  PubMed  Google Scholar 

  12. Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117(25):3171–80.

    Article  PubMed  PubMed Central  Google Scholar 

  13. • Luo D, Cheng Y, Zhang H, Ba M, Chen P, Li H, et al. Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis. BMJ. 2020;370:m3222 There is a progressive associaction between blood pressure and cardiovascular eve.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Nardin C, Maki-Petaja KM, Miles KL. Yasmin, McDonnell BJ, Cockcroft JR, et al. Cardiovascular phenotype of elevated blood pressure differs markedly between young males and females: the Enigma Study. Hypertension. 2018;72(6):1277–84.

    Article  CAS  PubMed  Google Scholar 

  15. Dubey RK, Oparil S, Imthurn B, Jackson EK. Sex hormones and hypertension. Cardiovasc Res. 2002;53(3):688–708.

    Article  CAS  PubMed  Google Scholar 

  16. Khalil RA. Sex hormones as potential modulators of vascular function in hypertension. Hypertension. 2005;46(2):249–54.

    Article  CAS  PubMed  Google Scholar 

  17. Pechère-Bertschi A, Burnier M. Female sex hormones, salt, and blood pressure regulation. Am J Hypertens. 2004;17(10):994–1001.

    Article  PubMed  Google Scholar 

  18. Colafella KMM, Denton KM. Sex-specific differences in hypertension and associated cardiovascular disease. Nat Rev Nephrol. 2018;14(3):185–201.

    Article  PubMed  Google Scholar 

  19. Chapman AB, Zamudio S, Woodmansee W, Merouani A, Osorio F, Johnson A, et al. Systemic and renal hemodynamic changes in the luteal phase of the menstrual cycle mimic early pregnancy. Am J Phys. 1997;273(5):F777–82.

    CAS  Google Scholar 

  20. Dunne FP, Barry DG, Ferriss JB, Grealy G, Murphy D. Changes in blood pressure during the normal menstrual cycle. Clin Sci (Lond). 1991;81(4):515–8.

    Article  CAS  Google Scholar 

  21. Karpanou EA, Vyssoulis GP, Georgoudi DG, Toutouza MG, Toutouzas PK. Ambulatory blood pressure changes in the menstrual cycle of hypertensive women. Significance of plasma renin activity values. Am J Hypertens. 1993;6(8):654–9.

    Article  CAS  PubMed  Google Scholar 

  22. Bentley-Lewis R, Seely E, Dunaif A. Ovarian hypertension: polycystic ovary syndrome. Endocrinol Metab Clin N Am. 2011;40(2):433–49 ix-x.

    Article  CAS  Google Scholar 

  23. Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162(16):1867–72.

    Article  PubMed  Google Scholar 

  24. Sharabi Y, Grotto I, Huerta M, Grossman E. Susceptibility of the influence of weight on blood pressure in men versus women: lessons from a large-scale study of young adults. Am J Hypertens. 2004;17(5 Pt 1):404–8.

    Article  PubMed  Google Scholar 

  25. Lima R, Wofford M, Reckelhoff JF. Hypertension in postmenopausal women. Curr Hypertens Rep. 2012;14(3):254–60.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Everett B, Zajacova A. Gender differences in hypertension and hypertension awareness among young adults. Biodemography Soc Biol. 2015;61(1):1–17.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Viera AJ, Neutze DM. Diagnosis of secondary hypertension: an age-based approach. Am Fam Physician. 2010;82(12):1471–8.

    PubMed  Google Scholar 

  28. Wenger NK, Arnold A, Bairey Merz CN, Cooper-DeHoff RM, Ferdinand KC, Fleg JL, et al. Hypertension across a woman’s life cycle. J Am Coll Cardiol. 2018;71(16):1797–813.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Pappadis SL, Somers MJ. Hypertension in adolescents: a review of diagnosis and management. Curr Opin Pediatr. 2003;15(4):370–8.

    Article  PubMed  Google Scholar 

  30. Weir RJ, Briggs E, Mack A, Naismith L, Taylor L, Wilson E. Blood pressure in women taking oral contraceptives. Br Med J. 1974;1(5907):533–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Fisch IR, Frank J. Oral contraceptives and blood pressure. JAMA. 1977;237(23):2499–503.

    Article  CAS  PubMed  Google Scholar 

  32. Meade TW, Haines AP, North WR, Chakrabarti R, Howarth DJ, Stirling Y. Haemostatic, lipid, and blood-pressure profiles of women on oral contraceptives containing 50 microgram or 30 microgram oestrogen. Lancet. 1977;2(8045):948–51.

    Article  CAS  PubMed  Google Scholar 

  33. Wilson ES, Cruickshank J, McMaster M, Weir RJ. A prospective controlled study of the effect on blood pressure of contraceptive preparations containing different types and dosages of progestogen. Br J Obstet Gynaecol. 1984;91(12):1254–60.

    Article  CAS  PubMed  Google Scholar 

  34. Chasan-Taber L, Willett WC, Manson JE, Spiegelman D, Hunter DJ, Curhan G, et al. Prospective study of oral contraceptives and hypertension among women in the United States. Circulation. 1996;94(3):483–9.

    Article  CAS  PubMed  Google Scholar 

  35. Lubianca JN, Moreira LB, Gus M, Fuchs FD. Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension. J Hum Hypertens. 2005;19(6):451–5.

    Article  CAS  PubMed  Google Scholar 

  36. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception. 2004;69(2):89–97.

    Article  CAS  PubMed  Google Scholar 

  37. Aisien AO, Enosolease ME. Safety, efficacy and acceptability of implanon a single rod implantable contraceptive (etonogestrel) in University of Benin Teaching Hospital. Niger J Clin Pract. 2010;13(3):331–5.

    CAS  PubMed  Google Scholar 

  38. Dorflinger LJ. Metabolic effects of implantable steroid contraceptives for women. Contraception. 2002;65(1):47–62.

    Article  CAS  PubMed  Google Scholar 

  39. Morin-Papunen L, Martikainen H, McCarthy MI, Franks S, Sovio U, Hartikainen AL, et al. Comparison of metabolic and inflammatory outcomes in women who used oral contraceptives and the levonorgestrel-releasing intrauterine device in a general population. Am J Obstet Gynecol. 2008;199(5):529.e1–e10.

    Article  Google Scholar 

  40. Shufelt CL, Bairey Merz CN. Contraceptive hormone use and cardiovascular disease. J Am Coll Cardiol. 2009;53(3):221–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Olatunji LA, Seok YM, Igunnu A, Kang SH, Kim IK. Combined oral contraceptive-induced hypertension is accompanied by endothelial dysfunction and upregulated intrarenal angiotensin II type 1 receptor gene expression. Naunyn Schmiedeberg's Arch Pharmacol. 2016;389(11):1147–57.

    Article  CAS  Google Scholar 

  42. Machado RB, Fabrini P, Cruz AM, Maia E, da Cunha Bastos A. Clinical and metabolic aspects of the continuous use of a contraceptive association of ethinyl estradiol (30 microg) and gestodene (75 microg). Contraception. 2004;70(5):365–70.

    Article  CAS  PubMed  Google Scholar 

  43. ACOG Practice Bulletin No. 206. Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2019;133(2):e128–e50.

    Article  Google Scholar 

  44. Curtis KM, Jatlaou TC, Tepper NK, et al. U.S. Selected practice, recommendations for contraceptive use. MMWR Recomm Rep. 2016;65(4):1–66. https://doi.org/10.15585/mmwr.rr6504a1R-D.

    Article  PubMed  Google Scholar 

  45. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237–60. https://doi.org/10.1097/AOG.0000000000003891.

  46. ACOG Practice Bulletin No. 203. Chronic hypertension in pregnancy. Obstet Gynecol. 2019;133(1):e26–50.

    Article  Google Scholar 

  47. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122–31. https://doi.org/10.1097/01.AOG.0000437382.03963.88.

  48. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138(17):e426–e83.

    PubMed  Google Scholar 

  49. Sinkey RG, Battarbee AN, Bello NA, Ives CW, Oparil S, Tita ATN. Prevention, diagnosis, and management of hypertensive disorders of pregnancy: a comparison of international guidelines. Curr Hypertens Rep. 2020;22(9):66.

    Article  PubMed  Google Scholar 

  50. Churchill D, Beevers GD, Meher S, Rhodes C. Diuretics for preventing pre-eclampsia. Cochrane Database Syst Rev. 2007(1):CD004451.

  51. Committee Opinion No. 623. Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2015;125(2):521–5.

    Article  Google Scholar 

  52. United States Preventive Task Force. Preeclampsia screening. https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/preeclampsia-screening. 2020, Accessed December 28, 2020.

  53. Tucker KL, Bankhead C, Hodgkinson J, Roberts N, Stevens R, Heneghan C, et al. How do home and clinic blood pressure readings compare in pregnancy? Hypertension. 2018;72(3):686–94.

    Article  CAS  PubMed  Google Scholar 

  54. Mikami Y, Takai Y, Era S, Ono Y, Saitoh M, Baba K, et al. Provisional criteria for the diagnosis of hypertension in pregnancy using home blood pressure measurements. Hypertens Res. 2017;40(7):679–84.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Dougall G, Franssen M, Tucker KL, Yu LM, Hinton L, Rivero-Arias O, et al. Blood pressure monitoring in high-risk pregnancy to improve the detection and monitoring of hypertension (the BUMP 1 and 2 trials): protocol for two linked randomised controlled trials. BMJ Open. 2020;10(1):e034593.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Pealing LM, Tucker KL, Mackillop LH, Crawford C, Wilson H, Nickless A, et al. A randomised controlled trial of blood pressure self-monitoring in the management of hypertensive pregnancy. OPTIMUM-BP: A feasibility trial. Pregnancy Hypertens. 2019;18:141–9.

    Article  PubMed  Google Scholar 

  57. Bello NA, Woolley JJ, Cleary KL, Falzon L, Alpert BS, Oparil S, et al. Accuracy of blood pressure measurement devices in pregnancy: a systematic review of validation studies. Hypertension. 2018;71(2):326–35.

    Article  CAS  PubMed  Google Scholar 

  58. Van Den Heuvel JFM, Lely AT, Franx A, Bekker MN. Validation of the iHealth Track and Omron HEM-9210T automated blood pressure devices for use in pregnancy. Pregnancy Hypertens. 2019;15:37–41.

    Article  Google Scholar 

  59. Topouchian J, Hakobyan Z, Asmar J, Gurgenian S, Zelveian P, Asmar R. Clinical accuracy of the Omron M3 Comfort. Vasc Health Risk Manag. 2018;14:189–97.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Takahashi H, Yoshika M, Yokoi T. Validation of two automatic devices for the self-measurement of blood pressure according to the ANSI/AAMI/ISO81060-2:2009 guidelines: the Omron BP765 (HEM-7311-ZSA) and the Omron BP760N (HEM-7320-Z). Vasc Health Risk Manag. 2015;11:49–53.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Abou-Dakn M, Wenzel S. Validation of the PHYSIO-PORT UP ambulatory blood pressure monitor in pregnant women according to the European Society of Hypertension International Protocol revision 2010. J Hum Hypertens. 2018;32(11):770–4.

    Article  PubMed  Google Scholar 

  62. Black MH, Zhou H, Sacks DA, Dublin S, Lawrence JM, Harrison TN, et al. Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery. J Hypertens. 2016;34(4):728–35.

    Article  CAS  PubMed  Google Scholar 

  63. Stuart JJ, Tanz LJ, Missmer SA, Rimm EB, Spiegelman D, James-Todd TM, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: an observational cohort study. Ann Intern Med. 2018;169(4):224–32.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Luoto R, Kharazmi E, Whitley E, Raitanen J, Gissler M, Hemminki E. Systolic hypertension in pregnancy and cardiovascular mortality: a 44-year follow-up study. Hypertens Pregnancy. 2008;27(1):87–94.

    Article  PubMed  Google Scholar 

  65. Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2017;10(2):e003497.

    Article  PubMed  Google Scholar 

  66. Mikami Y, Matsumoto T, Kano K, Toriumi T, Somei M, Honda MJ, et al. Current status of drug therapies for osteoporosis and the search for stem cells adapted for bone regenerative medicine. Anat Sci Int. 2014;89(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  67. Sibai BM. Etiology and management of postpartum hypertension-preeclampsia. Am J Obstet Gynecol. 2012;206(6):470–5.

    Article  PubMed  Google Scholar 

  68. Podymow T, August P. Postpartum course of gestational hypertension and preeclampsia. Hypertens Pregnancy. 2010;29(3):294–300.

    Article  PubMed  Google Scholar 

  69. Goel A, Maski MR, Bajracharya S, Wenger JB, Zhang D, Salahuddin S, et al. Epidemiology and mechanisms of de novo and persistent hypertension in the postpartum period. Circulation. 2015;132(18):1726–33.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Matthys LA, Coppage KH, Lambers DS, Barton JR, Sibai BM. Delayed postpartum preeclampsia: an experience of 151 cases. Am J Obstet Gynecol. 2004;190(5):1464–6.

    Article  PubMed  Google Scholar 

  71. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The International Glossary on Infertility and Fertility Care, 2017. Fertil Steril. 2017;108(3):393–406.

    Article  PubMed  Google Scholar 

  72. Davies MJ, Rumbold AR, Moore VM. Assisted reproductive technologies: a hierarchy of risks for conception, pregnancy outcomes and treatment decisions. J Dev Orig Health Dis. 2017;8(4):443–7.

    Article  CAS  PubMed  Google Scholar 

  73. Almasi-Hashiani A, Omani-Samani R, Mohammadi M, Amini P, Navid B, Alizadeh A, et al. Assisted reproductive technology and the risk of preeclampsia: an updated systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019;19(1):149.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Thomopoulos C, Salamalekis G, Kintis K, Andrianopoulou I, Michalopoulou H, Skalis G, et al. Risk of hypertensive disorders in pregnancy following assisted reproductive technology: overview and meta-analysis. J Clin Hypertens (Greenwich). 2017;19(2):173–83.

    Article  Google Scholar 

  75. Opdahl S, Henningsen AA, Tiitinen A, Bergh C, Pinborg A, Romundstad PR, et al. Risk of hypertensive disorders in pregnancies following assisted reproductive technology: a cohort study from the CoNARTaS group. Hum Reprod. 2015;30(7):1724–31.

    Article  CAS  Google Scholar 

  76. Tandberg A, Klungsøyr K, Romundstad LB, Skjærven R. Pre-eclampsia and assisted reproductive technologies: consequences of advanced maternal age, interbirth intervals, new partner and smoking habits. BJOG. 2015;122(7):915–22.

    Article  CAS  PubMed  Google Scholar 

  77. Thomopoulos C, Tsioufis C, Michalopoulou H, Makris T, Papademetriou V, Stefanadis C. Assisted reproductive technology and pregnancy-related hypertensive complications: a systematic review. J Hum Hypertens. 2013;27(3):148–57.

    Article  CAS  PubMed  Google Scholar 

  78. Daniel Y, Schreiber L, Geva E, Amit A, Pausner D, Kupferminc MJ, et al. Do placentae of term singleton pregnancies obtained by assisted reproductive technologies differ from those of spontaneously conceived pregnancies? Hum Reprod. 1999;14(4):1107–10.

    Article  CAS  PubMed  Google Scholar 

  79. Conrad KP, Baker VL. Corpus luteal contribution to maternal pregnancy physiology and outcomes in assisted reproductive technologies. Am J Phys Regul Integr Comp Phys. 2013;304(2):R69–72.

    CAS  Google Scholar 

  80. Udell JA, Lu H, Redelmeier DA. Long-term cardiovascular risk in women prescribed fertility therapy. J Am Coll Cardiol. 2013;62(18):1704–12.

    Article  PubMed  Google Scholar 

  81. Westerlund E, Brandt L, Hovatta O, Wallén H, Ekbom A, Henriksson P. Incidence of hypertension, stroke, coronary heart disease, and diabetes in women who have delivered after in vitro fertilization: a population-based cohort study from Sweden. Fertil Steril. 2014;102(4):1096–102.

    Article  PubMed  Google Scholar 

  82. Rosato E, Perrone G, Capri O, Galoppi P, Candelieri M, Marcoccia E, et al. Hypertension and early menopause after the use of assisted reproductive technologies in women aged 43 years or older: long-term follow-up study. J Obstet Gynaecol Res. 2016;42(12):1782–8.

    Article  PubMed  Google Scholar 

  83. Barton M, Meyer MR. Postmenopausal hypertension: mechanisms and therapy. Hypertension. 2009;54(1):11–8.

    Article  CAS  PubMed  Google Scholar 

  84. Yanes LL, Reckelhoff JF. Postmenopausal hypertension. Am J Hypertens. 2011;24(7):740–9.

    Article  PubMed  Google Scholar 

  85. Reckelhoff JF, Fortepiani LA. Novel mechanisms responsible for postmenopausal hypertension. Hypertension. 2004;43(5):918–23.

    Article  CAS  PubMed  Google Scholar 

  86. Gerber LM, Sievert LL, Warren K, Pickering TG, Schwartz JE. Hot flashes are associated with increased ambulatory systolic blood pressure. Menopause. 2007;14(2):308–15.

    Article  PubMed  Google Scholar 

  87. Routledge FS, McFetridge-Durdle JA, Dean CR. Stress, menopausal status and nocturnal blood pressure dipping patterns among hypertensive women. Can J Cardiol. 2009;25(6):e157–63.

    Article  PubMed  PubMed Central  Google Scholar 

  88. McSweeney JC, Rosenfeld AG, Abel WM, Braun LT, Burke LE, Daugherty SL, et al. Preventing and experiencing ischemic heart disease as a woman: state of the science: a scientific statement from the American Heart Association. Circulation. 2016;133(13):1302–31.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–33.

    Article  CAS  Google Scholar 

  90. Kling JM, Lahr BA, Bailey KR, Harman SM, Miller VM, Mulvagh SL. Endothelial function in women of the Kronos Early Estrogen Prevention Study. Climacteric. 2015;18(2):187–97.

    Article  CAS  PubMed  Google Scholar 

  91. Butkevich A, Abraham C, Phillips RA. Hormone replacement therapy and 24-hour blood pressure profile of postmenopausal women. Am J Hypertens. 2000;13(9):1039–41.

    Article  CAS  PubMed  Google Scholar 

  92. Cagnacci A, Rovati L, Zanni A, Malmusi S, Facchinetti F, Volpe A. Physiological doses of estradiol decrease nocturnal blood pressure in normotensive postmenopausal women. Am J Phys. 1999;276(4):H1355–60.

    CAS  Google Scholar 

  93. Bath PM, Gray LJ. Association between hormone replacement therapy and subsequent stroke: a meta-analysis. BMJ. 2005;330(7487):342.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007;297(13):1465–77.

    Article  CAS  PubMed  Google Scholar 

  95. Hsia J, Langer RD, Manson JE, Kuller L, Johnson KC, Hendrix SL, et al. Conjugated equine estrogens and coronary heart disease: the Women’s Health Initiative. Arch Intern Med. 2006;166(3):357–65.

    Article  CAS  PubMed  Google Scholar 

  96. Salpeter SR, Walsh JM, Greyber E, Salpeter EE. Brief report: coronary heart disease events associated with hormone therapy in younger and older women. A meta-analysis J Gen Intern Med. 2006;21(4):363–6.

    Article  PubMed  Google Scholar 

  97. Dubey RK, Imthurn B, Zacharia LC, Jackson EK. Hormone replacement therapy and cardiovascular disease: what went wrong and where do we go from here? Hypertension. 2004;44(6):789–95.

    Article  CAS  PubMed  Google Scholar 

  98. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–e528.

    Article  PubMed  Google Scholar 

  99. Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol. 1994;24(2):471–6.

    Article  CAS  PubMed  Google Scholar 

  100. Sandberg K, Ji H. Sex differences in primary hypertension. Biol Sex Differ. 2012;3(1):7.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Sun Z. Aging, arterial stiffness, and hypertension. Hypertension. 2015;65(2):252–6.

    Article  CAS  PubMed  Google Scholar 

  102. Buford TW. Hypertension and aging. Ageing Res Rev. 2016;26:96–111.

    Article  PubMed  PubMed Central  Google Scholar 

  103. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–16.

    Article  CAS  PubMed  Google Scholar 

  104. Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA. 2016;315(24):2673–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98.

    Article  CAS  PubMed  Google Scholar 

  106. Benetos A, Petrovic M, Strandberg T. Hypertension management in older and frail older patients. Circ Res. 2019;124(7):1045–60.

    Article  CAS  PubMed  Google Scholar 

  107. de Bruijn RF, Bos MJ, Portegies ML, Hofman A, Franco OH, Koudstaal PJ, et al. The potential for prevention of dementia across two decades: the prospective, population-based Rotterdam Study. BMC Med. 2015;13:132.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005;4(8):487–99.

    Article  PubMed  Google Scholar 

  109. Chen KH, Henderson VW, Stolwyk RJ, Dennerstein L, Szoeke C. Prehypertension in midlife is associated with worse cognition a decade later in middle-aged and older women. Age Ageing. 2015;44(3):439–45.

    Article  PubMed  Google Scholar 

  110. •• Jin X, Chandramouli C, Allocco B, Gong E, Lam CSP, Yan LL. Women’s participation in cardiovascular clinical trials from 2010 to 2017. Circulation. 2020;141(7):540–8 Women are still disproportionately represented in cardiovascular trials.

    Article  PubMed  Google Scholar 

  111. U.S. Census Bureau QuickFacts. (2019). https://www.census.gov/quickfacts/fact/table/US/PST045219 (Accessed on January 28, 2021)

  112. Pearson GD, Mensah GA, Rosenberg Y, Stoney CM, Kavounis K, Goff DC. National heart, lung, and blood institute cardiovascular clinical trial perspective. Am Heart J. 2020;224:25–34.

    Article  PubMed  Google Scholar 

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Funding

Dr. Bello has research funding from NIH/NHLBI (K23 HL136853 R01 HL153382).

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Authors and Affiliations

  1. School of Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, USA

    Lama Ghazi

  2. Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, PH 3-342, New York, NY, 10032, USA

    Natalie A. Bello

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  1. Lama Ghazi
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  2. Natalie A. Bello
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Correspondence to Natalie A. Bello.

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Dr. Bello has nothing to disclose.

Dr. Ghazi has nothing to disclose.

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This article is part of the Topical Collection on Women and Ischemic Heart Disease

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Ghazi, L., Bello, N.A. Hypertension in Women Across the Lifespan. Curr Atheroscler Rep 23, 43 (2021). https://doi.org/10.1007/s11883-021-00941-4

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