A generation ago, America’s academic community left behind the pseudoscientific message of The Bell Curve along with suggestions from Larry Summers, then Harvard’s president, that men and women might differ in aspects of intelligence. Yet, the obverse is true now in modern medicine as researchers learn more about the subtler differences among humans from group to group.
Among those differences, doctors may need to treat hypertension much earlier and more aggressively in women than in men. A new study from Wake Forest Baptist Medical Center shows significant differences in the biological causes of high blood pressure between the sexes. Carlos Ferrario and his colleagues there analyzed data from 100 men and and women ages 53 and older, all of whom suffered untreated hypertension without other major diseases.
"The medical community thought that high blood pressure was the same for both sexes and treatment was based on that premise," Ferrario said in a statement.
In the study, researchers evaluated the participants using a battery of tests measuring the functioning of the circulatory system -- hemodynamics -- along with the hormonal mechanisms partially causing the disease in men and women.
“Despite there being no differences between women and men in terms of office blood pressure, heart rate and body mass index, men demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity and augmentation index,” the researchers wrote. “ In each of the three hypertension categories, the increased blood pressure in men was associated with significant augmentations in stroke volume and cardiac output compared with women.”
With everything equal, the researchers found huge differences between men and women in the rate of disease. Women suffered vascular disease at a rate 30-40 percent higher than men with similar levels of high blood pressure.
Additionally, Ferrario’s team found significant physiologic differences in the female cardiovascular system, including hormonal differences important to blood pressure regulation, which contribute to heart disease, the researchers said.
“The impact of sex differences in the hemodynamic factors accounting for the elevation in arterial pressure in subjects with essential hypertension has been poorly characterized or this information is not available,” the researchers wrote.”We suggest that this gap in knowledge may adversely influence choices of drug treatment since our study shows for the first time significant differences in the hemodynamic and hormonal mechanisms accounting for the increased blood pressure in women compared to men.”
Aside from differences between men and women, a greater susceptibility to the disease has been observed among African American men since the 1960s, according to the Centers for Disease Control and Prevention.
Source: Ferrario, Carlos M., Jessup, Jewell A., Smith, Ronald D. Therapeutic Advances In Cardiovascular Disease. 2013