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Hypertension Harder to Control in Women

They don't respond as well as men to drugs, finds study

WEDNESDAY, Nov. 12, 2003 (HealthDayNews) -- While women often receive more aggressive treatment for high blood pressure, those medications don't lower their blood pressure readings as much as they do for men.

That's the conclusion of a study being presented Nov. 12 at the American Heart Association's annual conference in Orlando, Fla.

"Women tended to be on more medications," says study author Dr. Kristin Newby, an associate professor of medicine at Duke University Medical Center. "Instead of just a single agent, women tended to be on two to three drugs [to control hypertension]."

Despite this, "there was no measurable impact on blood pressure," Newby adds.

While she says it's impossible to know why this is happening in this particular study, she says it raises a whole new set of questions for researchers, such as: Are women getting the medications in adequate doses, or is blood pressure simply harder to control in women?

Dr. Franz Messerli, director of clinical hypertension at Ochsner Clinic Foundation Hospital in New Orleans, says an encouraging finding in the study is that even though women received intense antihypertensive therapy and were not as well-controlled as men, "their outcomes are about the same."

"It's harder for women to get to the goals [normal blood pressure readings], but despite that, women do remarkably well," he says.

Hypertension is a serious problem in the United States and around the world. Having high blood pressure raises your risk of heart disease, stroke and kidney problems.

As many as one in four Americans has high blood pressure, according to the American Heart Association, yet nearly a third don't know it. The National Heart, Lung, and Blood Institute reports that in women, about 75 percent know they have hypertension, but less than one in three are controlling it well.

For this study, Newby and her colleagues gathered data from two other heart disease studies in progress. The researchers included 2,091 women and 5,084 men from across the United States.

Nearly two-thirds of the women and half of the men had high blood pressure. The women's average systolic -- the top number -- blood pressure was slightly higher than the men's, 150 versus 147.

The women with high blood pressure tended to be older and were more likely to have reduced kidney function, diabetes and a history of heart failure. She says the women with hypertension were less likely to be smokers or to have had a prior heart attack.

The most commonly used medications to treat high blood pressure include ACE inhibitors, beta blockers, calcium channel blockers and diuretics.

The researchers found that 16 percent of women were on three or more drugs to control their hypertension, while only 13 percent of men were on that many medications. About 35 percent of women versus 30 percent of men were on two medications for their high blood pressure.

Only one type of medication, diuretics, appeared to be prescribed to women more often than to men -- 33 percent in women compared to 19 percent in men.

Messerli says this may be because women may be more prone to edema -- swelling -- of the ankles. Diuretics, which are commonly known as water pills, help reduce fluid buildup.

Newby says it's important for everyone to get their blood pressure checked and to know their number. If you're overweight, Messerli says it's important to lose weight and that everyone should exercise regularly. Smokers should quit smoking. And if you've been diagnosed with high blood pressure, you need to watch the amount of sodium in your diet and make sure that you take your medications every day as prescribed.

"High blood pressure is not a disease that makes you feel bad, but you have to take your medication every day," Newby says.

More information

For more information on high blood pressure, go to the American Heart Association. To learn more about treating high blood pressure, visit the National Heart, Lung, and Blood Institute.

SOURCES: Kristin Newby, M.D., associate professor, medicine, Duke University Medical Center, Durham, N.C.; Franz Messerli, M.D., director, clinical hypertension, Ochsner Clinic Foundation Hospital, and clinical professor, medicine, Tulane Medical School, New Orleans; Nov. 12, 2003, presentation, American Heart Association Scientific Sessions 2003, Orlando, Fla.
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