title: Premenopausal women have increased risk of hypertensive target organ damage compared with men of similar age.
abstract: BACKGROUND
  The impact of high blood pressure (BP) on target organs (TO) in premenopausal women is not well known. The purpose of this study was to describe gender differences in TO involvement in a cohort of young-to-middle-aged subjects screened for stage 1 hypertension and followed for 8.2 years.
  
  
  METHODS
  Participants were 175 women and 451 men with similar age (range 18-45 years). Ambulatory BP at entry was 127.5±12.5/83.7±7.2 mm Hg in women and 131.9±10.3/81.0±7.9 mm Hg in men. Ambulatory BP, albumin excretion rate (AER), and echocardiographic data (n=489) were obtained at entry, every 5 years, and before starting antihypertensive treatment.
  
  
  RESULTS
  Female gender was an independent predictor of final AER (p=0.01) and left ventricular mass index (LVMI) (p<0.001). At follow-up end, both microalbuminuria (13.7% vs. 6.2%, p=0.002) and left ventricular hypertrophy (LVH) (26.4% vs. 8.8%, p<0.0001) were more common among women than men. In a multivariable Cox analysis, after adjusting for age, lifestyle factors, body mass, ambulatory BP, heart rate, and parental hypertension, female gender was a significant predictor of time to development of microalbuminuria (p=0.002), with a hazard ratio (HR) of 3.06, (95% confidence interval [CI] 1.48-6.34) and of LVH (p=0.004), with an HR of 2.50 (1.33-4.70). Inclusion of systolic and diastolic BP changes over time in the models only marginally affected these associations, with HRs of 3.13 (1.50-6.55) and 3.43 (1.75-6.70), respectively.
  
  
  CONCLUSIONS
  These data indicate that premenopausal women have an increased risk of hypertensive TO damage (TOD) and raise the question about whether early antihypertensive treatment should be considered in these patients.
authors.affiliation: Clinica Medica 4, University of Padova, Via Giustiniani 2, Padua, Italy. palatini@unipd.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Palatini
authors.forename: Lucio
authors.initials: L
authors.lastname: Mos
authors.forename: Massimo
authors.initials: M
authors.lastname: Santonastaso
authors.forename: Francesca
authors.initials: F
authors.lastname: Saladini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Benetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Mormino
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bortolazzi
authors.forename: Susanna
authors.initials: S
authors.lastname: Cozzio
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000209:etiology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D016001:Confidence Intervals; D061345:Early Medical Intervention; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D058958:Organs at Risk; D017697:Premenopause; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D014463:Ultrasonography; D016387:Women's Health / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents