Gender Differences in Epidemiology, Pathophysiology, and Treatment of Hypertension

  • Paolo Di Giosia
  • Paolo Giorgini
  • Cosimo Andrea Stamerra
  • Marco Petrarca
  • Claudio Ferri
  • Amirhossein SahebkarEmail author
Women and Ischemic Heart Disease (A. Maran, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Women and Ischemic Heart Disease


Purpose of Review

This review aims to examine gender differences in both the epidemiology and pathophysiology of hypertension and to explore gender peculiarities on the effects of antihypertensive agents in decreasing BP and CV events.

Recent Findings

Men and women differ in prevalence, awareness, and control rate of hypertension in an age-dependent manner. Studies suggest that sex hormones changes play a pivotal role in the pathophysiology of hypertension in postmenopausal women. Estrogens influence the vascular system inducing vasodilatation, inhibiting vascular remodeling processes, and modulating the renin-angiotensin aldosterone system and the sympathetic system. This leads to a protective effect on arterial stiffness during reproductive age that is dramatically reversed after menopause.


Data on the efficacy of antihypertensive therapy between genders are conflicting, and the underrepresentation of aged women in large clinical trials could influence the results. Therefore, further clinical research is needed to uncover potential gender differences in hypertension to promote the development of a gender-oriented approach to antihypertensive treatment.


Hypertension Blood pressure Cardiovascular risk Gender Treatment disparities 


Compliance with Ethical Standards

Conflict of Interest

Paolo Di Giosia, Paolo Giorgini, Cosimo Andrea Stamerra, Marco Petrarca, Claudio Ferri, and Amirhossein Sahebkar declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Paolo Di Giosia
    • 1
  • Paolo Giorgini
    • 1
  • Cosimo Andrea Stamerra
    • 1
  • Marco Petrarca
    • 1
  • Claudio Ferri
    • 1
  • Amirhossein Sahebkar
    • 2
    • 3
    Email author
  1. 1.Department of Life, Health & Environmental SciencesUniversity of L’AquilaL’AquilaItaly
  2. 2.Biotechnology Research Center, Pharmaceutical Technology InstituteMashhad University of Medical SciencesMashhadIran
  3. 3.Neurogenic Inflammation Research CenterMashhad University of Medical SciencesMashhadIran

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