Why more men than women have high blood pressure

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Hypertension, commonly known as high blood pressure, exhibits a higher prevalence among men than women, and the underlying reasons for this discrepancy remain not fully understood.

To shed light on this matter, researchers at the University of Alabama at Birmingham, Marnix E. Heersink School of Medicine, conducted a comprehensive study involving nationwide data from over 200,000 individuals of diverse racial and ethnic backgrounds.

Their aim was to investigate the genetic factors contributing to sex differences in hypertension, as detailed in a recent study published in Circulation: Genomic and Precision Medicine.

The Significance of Hypertension

Hypertension affects nearly half of the United States population and stands as the most prominent risk factor for various cardiovascular diseases, including coronary heart disease, heart failure, and stroke.

The management of hypertension leads to substantial healthcare expenditure, amounting to almost $200 billion annually.

Predicting the development of hypertension could facilitate the implementation of preventive strategies aimed at reducing the risk of heart disease.

In this study, the researchers conducted genome-wide association studies (GWAS) focusing on systolic blood pressure (SBP) using data from the U.K. Biobank, which encompassed over 486,000 individuals representing diverse ancestral groups.

GWAS is an analytical method used to identify genetic risk factors that influence SBP. The investigators performed separate GWAS for each gender, allowing them to account for the varying effects of genetic variants on SBP based on sex.

The Findings

The study’s findings indicated that the genetic predisposition to developing hypertension, as reflected by sex-specific polygenic risk scores (PRS) for systolic blood pressure, exhibited a more profound association with hypertension in females compared to males.

Females with a high PRS faced a greater risk of hypertension than males with a high PRS, whereas females with a low PRS had a lower hypertension risk compared to their male counterparts.

Additionally, the research revealed that the relationship between genetic risk and hypertension varied before and after menopause.

Pre-menopausal women with a high genetic risk exhibited a higher hypertension risk than men, but post-menopause, the hypertension risk became similar between the sexes.

Implications and Future Directions

The study underscores the significant role genetics play in explaining sex differences in hypertension. It emphasizes the need for further investigations into the genetic variants exclusively associated with SBP in each gender.

Analyzing the functions of these genetic variants could advance understanding of sex-specific mechanisms regulating SBP and the potential for sex-specific responses to medications.

Pankaj Arora, M.D., the senior author of the study and an associate professor in the UAB Division of Cardiovascular Disease, highlighted that such research efforts are essential for comprehending gender disparities in cardiovascular disease.

These efforts pave the way for the development of precision medicine approaches to hypertension treatment, ultimately reducing gender-based disparities in the cardiovascular disease burden.

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The research findings can be found in Circulation: Genomic and Precision Medicine.

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