Citation

Turkkan JS. Women Ther. 1995; 16(1): 49-71.

Copyright

(Copyright © 1995, Informa - Taylor and Francis Group)

DOI

10.1300/J015v16n01_04

PMID

unavailable

Abstract

Recent epidemiological national surveys have shown the prevalence of uncontrolled high blood pressure in women to range between 8-11% in Caucasian women and between 16-23% in African-American women. The prevalence of uncontrolled blood pressure is slightly higher in men but because there are more women than men in the population, there is a larger absolute number of women than men with hypertension in the U.S. Although published guidelines for pharmacological interventions on high blood pressure have been "gender blind" to date, there is growing evidence that women may respond differently to selected antihypertensive therapies, both with regard to blood pressure control and cardiovascular morbidity and mortality endpoints, and also with regard to side effects and quality of life outcomes. Because women have not been included in many important antihypertensive drug trials, there has been a relative lack of information about a range of side effects that have been reported in isolatedlaboratory studies, trials and case reports. For example, unmedicated female hypertensives have been found to perform more poorly on perceptual tasks than unmedicated male hypertensives. Impaired neuropsychologicl function in female hypertensives prior to treatment may predispose to greater impairments during medication. Black women are at particular risk, as they have been shown in recent surveys to have the highest prevalence of hypertension among all groups surveyed. Yet only one hypertensive drug trial has recruited sufficient numbers of Black women to allow comparisons of blood pressure response, quality of life and objectively assessed psychomotor side effect profiles with Black men. Finally, although many studies have focused on side effects of antihypertensive agents on sexual function and experience in hypertensive male patients, the recent inclusion of women in large-scale drug trials has allowed sexual side effectsof antihypertensive pharmacotherapy to be examined in detail with use of gender-appropriate instruments for the first time. This paper reviews what is currently known about the unique features of pharmacological treatment of hypertension in women, with particular focus on central nervous system (CNS), sexual, subjective, and physical symptoms side effects. Data also are shown suggesting that women have different standards of preferred health states, potentially impacting on their responses to side effects during treatment.