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Gender Differences in Hypertension

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Hypertension is the leading risk factor for global mortality and morbidity and remains the major preventable cause of cardiovascular diseases. Gender differences in risk factors and awareness, treatment, and control of hypertension have been well established in humans. There are significant differences in epidemiology and clinical characteristic of hypertension between men and women. Moreover, gender differences are linked with several specific types of hypertension, including postmenopausal hypertension, white coat hypertension, masked hypertension, and hypertensive disorders of pregnancy. Gender differences have been implicated in the prevalence and determinants of hypertension and prehypertension whereas the control rate is similar between men and women taking antihypertensive medication. Importantly, distinct roles of the angiotensin-converting enzyme 2/Apelin signaling, sex hormone, endothelin-1, and sympathetic nervous activity contribute to sex differences in blood pressure control. This review summarizes gender differences in clinical features and determinants of hypertension and the underlying mechanisms responsible for hypertension.

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Ambulatory blood pressure monitoring


American College of Cardiology


Angiotensin-converting enzyme


Angiotensin-converting enzyme 2


Angiotensin-converting enzyme inhibitor


American Heart Association


Angiotensin 1–7


Angiotensin II


Angiotensin receptor blocker


Angiotensin II type 1 receptor


Angiotensin II type 2 receptor


Blood pressure


Calcium channel blockers


Cardiovascular diseases


Diastolic blood pressure


European Society of Cardiology


European Society of Hypertension




The Losartan Intervention For Endpoint Reduction in Hypertension Study


Masked hypertension


Nitric oxide


National Health and Nutrition Examination Survey


Renin-angiotensin system


Systolic blood pressure


Sympathetic nervous activity


White coat hypertension


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Correspondence to Jiu-Chang Zhong.

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Song, J., Ma, Z., Wang, J. et al. Gender Differences in Hypertension. J. of Cardiovasc. Trans. Res. 13, 47–54 (2020). https://doi.org/10.1007/s12265-019-09888-z

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  • Hypertension
  • Gender difference
  • Renin-angiotensin system
  • Sex hormone
  • Endothelin-1
  • Immune system