G.D. Radchenko, T.G. Slashcheva, Yu.M. Sirenko, L.O. Mushtenko. Gender differences of blood pressure control in patients with arterial hypertension

The aim – to compare blood pressure (BP) control in patients with arterial hypertension of the Ukrainian population and to define factors associated with failure of BP control during 3-month antihypertensive therapy in men and women.

Material and methods. 9821 patients (mean age 58.9±0.24 yrs) with BP > 140/90 mmHg were included in 3 months multicenter (62 towns and 531 primary care physicians) open trial. All patients were divided into 2 groups: 1st – 5944 females; 2nd – 3877 men. The primary care physicians prescribed drugs according to their discretion. Office BP measurements, ECG, compliance and cardiovascular risk evaluations were performed at all visits. Multifactor regression analysis was used for evaluation of antihypertensive treatment failure predictors.

Results. In women, compared to men, arterial hypertension was associated with more frequent complications, such as heart failure (48.4 vs 45.8 %, Р=0.02) and stroke (17.8 vs 15.8 % Р=0.02), concomitant states (diabetes mellitus – 15.2 vs 12.1 %, Р<0.001, renal damage – 23 vs 20.4 %, Р=0.005) and risk factors (obesity – 37.1 vs 21 %, Р<0.001, family history – 65.6 vs 63.3 %, Р=0,02, older age – 60.10±0.23 vs 58.5±0.3 years, Р<0.001, high systolic BP – 166.40±0.24 vs 165.20±0.27 mmHg, Р=0.001). The men had more frequent history of myocardial infarction (15.6 vs 6.2 %, Р<0.001) and risk factors (smoking, alcohol and salt abuse). At the same time, additional physical activity was more prevalent in men (57.2 vs 47.7 %, Р<0.001). At baseline, only 23.6 % patients of 1st group and 20.9 % of 2nd group (Р<0.01) had high drug compliance. At the end of the study more men were characterized as incompliant, than women (27.1 vs 31.4 %, Р<0.001). In women BP control after 3-months antihypertensive therapy was worse than in men – 50.6 vs 58.3 % (Р<0.001). Conclusion. Thus, BP control was better in men, than in women, despite better compliance in women. Men and women had differences in factors associated with poor BP control. Therefore, they may need different hypertension management. In women it is necessary to modify lifestyle in order to decrease of body mass index and increase vegetable/fruit consumption. In men it is necessary to increase physical activity and drug compliance.

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