Strategies for the Treatment of Hypertension in Postmenopausal Women.
Coronary heart disease (CHD) remains the leading cause of death in women. Although premenopausal women experience less CHD than men, mortality from CHD increases more rapidly in women over the age of 60. There are also significant racial differences in mortality among women. Some of these differences can be attributed to genetics, but there are fundamental differences in practice patterns which might contribute to inequality. Coincident with the recent increase in CHD mortality is a growing failure to adequately treat hypertension. The current guidelines for the treatment of hypertension are gender neutral. However, this approach does not account for differences in side effects or treatment failure rates, which vary by gender. It also does not account for gender specific physiologic differences in susceptibility to CHD. This review summarizes the clinical profile of hypertension in women, the rationale for treatment, and the consequences of therapy, with an emphasis on age and gender biased risk assessment. The results of recent trials of antihypertensive therapy in postmenopausal women are reviewed. (c)1999 by Le Jacq Communications, Inc.
Hanes
Donna S.
DS
University of Maryland Hospital, Division of Nephrology, University of Maryland, Baltimore, MD.