Women have a lower normal blood pressure than men, which suggests they should be treated for hypertension when their systolic BP is higher than 110, below the current 120 standard used for both sexes.
“Our latest findings suggest that this one-size-fits-all approach to considering blood pressure may be detrimental to a woman’s health,” said Susan Cheng, MD, MPH, MMSc, associate professor of Cardiology and director of the Institute for Research on Healthy Aging in the Department of Cardiology at the Smidt Heart Institute at Cedars-Sinai and senior author of the study. “Based on our research results, we recommend that the medical community reassess blood pressure guidelines that do not account for sex differences.”
Cheng and her team looked at blood pressure measurements for more than 27,000 people, 54 percent of whom were women and found women had a lower BP threshold than men for risk of risk of heart attack, heart failure and stroke.
Risk at lower thresholds similar to men at higher level
They observed that the risk for women at lower thresholds was comparable to what men have at the higher threshold.
“The MI risk for women with SBP 110 to 119 mm Hg was comparable with the MI risk for men with SBP ≥160 mm Hg; similarly, the HF risk for women with SBP 110 to 119 mm Hg was comparable with HF risk for men with SBP 120 to 129,” they wrote. “Stroke risk also manifested at sex-specific, albeit higher, thresholds: Risk for women with SBP 120 to 129 mm Hg was comparable with risk in men with SBP 140 to 149 mm Hg.”
Sex-agnostic targets may not work
Her previous research suggested that women’s blood vessels age faster than men’s. In both studies, they compared women to women and men to men rather than the more common method of comparing women to men.
“If the ideal physiologic range of blood pressure truly is lower for females than males, current approaches to using sex-agnostic targets for lowering elevated blood pressure need to be reassessed,” said Christine Albert, MD, MPH, chair of the Department of Cardiology at the Smidt Heart Institute. “This important work is far-reaching and has numerous clinical implications.”
Cheng notes the next step is to determine whether women should be treated for hypertension when their systolic blood pressure is higher than 110.
“Taken together, and on the background of previous work, our outcomes-based results suggest the possible need for a lower sex-specific definition of optimal SBP for women,” she wrote. “If the ideal physiologic range of BP truly is lower for women than for men, current approaches to using sex-agnostic targets for lowering elevated BP could benefit from careful reassessment.”