Gender Difference in Blood Pressure Control and Cardiovascular Risk Factors in Americans With Diagnosed Hypertension

Abstract

Hypertension is an important risk factor for cardiovascular disease, which is the leading cause of death in women. We, therefore, analyzed gender-specific trends in the control of blood pressure and prevalence of 5 other cardiovascular risk factors (central obesity, elevated total cholesterol, low high-density lipoprotein cholesterol, hyperglycemia, and smoking) among adults with diagnosed hypertension in the United States. We included 3475 participants aged ≥18 years with diagnosed hypertension in the National Health and Nutrition Examination Survey 1999–2004. The age-adjusted prevalence of uncontrolled blood pressure was 50.8±2.1% in men and 55.9±1.5% in women, which were not significantly different and had not changed significantly with time. Central obesity, elevated total cholesterol level, and low high-density lipoprotein cholesterol were significantly more prevalent in women than in men (79.0±1.0%, 61.3±1.6%, and 39.7±1.6% versus 63.9±1.6%, 48.1±1.8%, and 35.6±1.7%, respectively; P <0.05). The age-adjusted proportion with ≥3 of the 6 risk factors studied was higher in women than in men (52.5±1.4% versus 40.9±1.8%; P <0.001), and this proportion decreased significantly by 7.7% in women from 1999–2000 to 2003–2004 ( P <0.05) but not in men. Our study shows that blood pressure control in women with diagnosed hypertension was not significantly inferior compared with men and had not changed significantly in 1999–2004. However, women had higher prevalence of other concomitant cardiovascular risk factors. Although there is room for improvement in blood pressure control, our study has highlighted the importance of addressing concomitant cardiovascular risk factors in women with hypertension.