Apr 23, In this study, we will assess the frequency of hypertension among healthy university students and its association with gender, body mass index. May 25, Overall, the prevalence of hypertension was higher in men (%) than in distinct relationship between BMI and hypertension control among women. . Age Dependent Gender Differences in Hypertension Management. gender difference in blood pressure a man's, and new research has shown significant differences in the causes of high blood pressure between the sexes.
Based on the more prominent role of the AT2 receptor in the control of cardiovascular and renal health in females compared to males, it is feasible that the enhanced anti-inflammatory profile in females is related to greater AT2 receptor expression in females.
Studies are needed to directly test this hypothesis. Male mice genetically deficient in the AT1 receptor on T cells have exacerbated kidney injury in response to Ang II infusion, without any further effect on BP While little is known regarding the role of AT2 receptors on T cells in Ang II hypertension, intramyocardial injection of T cells expressing the AT2 receptor reduced infarct size and improved cardiac performance post myocardial infarction in male rats suggesting a beneficial role for T cell AT2 receptors in cardiovascular disease as well Further studies are needed to better elucidate the role of T cell RAS receptors in both sexes.
Summary and Conclusions Recent advances in basic science research have identified several possible mechanisms responsible for the observed sex differences in hypertension.
Sex Differences in Hypertension: Recent Advances
In this review, we focused on recent publications implicating the divergent role of the immune system in hypertensive males and females. We propose that the greater anti-inflammatory immune profile in females during hypertension may act as a compensatory mechanism to limit increases in BP compared to males who exhibit a more pro-inflammatory immune profile.
However, the mechanisms underlying these changes in immune cells in hypertensive males and females are not yet well understood. One possible mediator is the AT2 receptor, which has previously been shown to have greater activity in females, and recent studies indicate the AT2 receptor promotes an anti-inflammatory immune profile.
Further research to elucidate the complex role of the immune system in hypertension in both sexes is critical, and may aid in discovering new therapeutic pathways to better control BP in both sexes. Footnotes None References 1. Trends in blood pressure among adults with hypertension: United States, to Heart disease and stroke statistics update: A report from the American Heart Association. Exploring the biological contributions to human health: A randomized clinical trial.
Ambulatory blood pressure monitoring in subjects from 11 populations highlights missed opportunities for cardiovascular prevention in women. Differences between men and women in ambulatory blood pressure thresholds for diagnosis of hypertension based on cardiovascular outcomes.
Thresholds for conventional and home blood pressure by sex and age in participants from 5 populations. Role of the t cell in the genesis of angiotensin ii induced hypertension and vascular dysfunction.
What's sex got to do with it? Sex and the renin-angiotensin system: Introduction The Middle East is known to have a significantly higher percentage of younger populations compared to the west, with the prevalence of disabling cardiovascular diseases in those younger populations significantly higher compared to western populations [ 1 ].
Moreover, the healthier the younger populations, the higher the educational achievement and the more productive they are for their developing societies [ 2 ]. A previous study showed that, in developing countries, younger populations are poorly screened for diseases, especially those associated with long-term outcomes [ 3 ]. Hypertension is one of the major risk factors associated with cardiovascular diseases, and it is also a component of the metabolic syndrome [ 4 ].
Recently, the American Heart Association and the American College of Cardiology issued new guidelines to diagnose hypertension [ 5 ].
In these guidelines, they lowered the limit to diagnose stage 1 hypertension from mmHg systolic and 90 mmHg diastolic to mmHg systolic and 80 mmHg diastolic. Lowering the limit for hypertension diagnosis will increase the number of adolescents diagnosed as hypertensive. A recent study in the Philippines found a frequency of hypertension around 2.
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In this study, we included healthy university students from healthcare faculties looking for the frequency of hypertension and the effects of gender, BMI, smoking, and family history of both hypertension and cardiovascular diseases. Participants We recruited university students studying at the University of Jordan in healthcare faculties, including faculty of medicine, pharmacy, and nursing.
We only included healthy students i. Each participant involved in this study had a previous detailed checkup upon admission to the university; the checkup included a complete history and physical examination, in addition to complete blood count and urine analysis.
Gender Differences in Hypertension and Hypertension Awareness Among Young Adults
We recruited participants via an announcement published in relevant social media websites. Each eligible participant was instructed not to take any stimulant before blood pressure measurement e. Three of the authors A. They measured blood pressure for each arm twice and recorded the mean for each arm, but we only included the higher mean reading for each participant.
Other Variables We obtained both family history of either hypertension or cardiovascular diseases either first degree, 2nd degree, or beyond and smoking history measured in pack-year. We categorized BMI into the following groups: We also categorized both systolic and diastolic blood pressure into the groups shown in Table 2. Due to the small number of participants in each group, we transformed smoking status into either a smoker regardless of pack-year or a nonsmoker.
We used Chi-square test followed by -test for proportions to analyze the relation between hypertension status nonhypertensive, stage 1 hypertension, and stage 2 hypertension and both gender and BMI category. We used independent sample -test to analyze the mean difference in both systolic and diastolic blood pressure between each gender and between smoking statuses. We used one-way ANOVA to analyze the mean differences in both systolic and diastolic blood pressure for BMI and family history of both hypertension and cardiovascular diseases.
Results A total of participants were included in this study with a mean age of They were On the other hand, men have a higher prevalence of overweight than women Flegal et al. Smoking prevalence is lower among women than men, although this gender difference has narrowed over the previous decades Agaku, King, and Dube ; Waldron In contrast, physical activity tends to be higher among men than women Haskell et al.
Taken together, these behavioral differences suggest that competing behavioral factors e. Researchers examining hypertension typically rely on self-reports because only a small number of data sources include biomarker collection that includes blood pressure measurement. For the general population, the accuracy of self-reported morbidities in general is a known potential problem in measuring population health Ferraro and Farmer ; Giles et al.
Studies that have compared self-reported hypertension to objective measures of systolic and diastolic blood pressure have found relatively low levels of hypertension awareness among the general U.
For example, studies from the early s have found hypertension awareness to be as low as 43 percent Bowlin et al. Using more recent data from the —06 wave of the National Health and Nutrition Examination Survey NHANESOstchega and colleagues showed that only 78 percent of hypertensive adults—as determined by measured blood pressure—were aware of their hypertensive status.
There have not been major changes in the increasingly healthy lifestyles in the United States over the past decade and a half; thus, the improvements in hypertension awareness are most likely due to increases in the availability of screenings in nonclinical settings as well as improvements in hypertension education Chobanian Another reason for the differences in hypertension awareness rates could pertain to the average age of the respondents.
In general, older respondents tend to be more aware of their hypertensive status, while young adults tend to have particularly low hypertension awareness Egan, Zhao, and Axon Because younger individuals tend to be healthier, they are less likely to see doctors on a regular basis, decreasing the likelihood that they will have accurate and up-to-date knowledge of their blood pressure status. Few studies have examined the gender differences in hypertension awareness.
The existing research presents mixed results; some work has found that women have higher levels of hypertension awareness than men Egan, Zhao, and Axon ; Hajjar and Kotchenbut other work has suggested that hypertension awareness is higher among men than women Guo et al.
From the perspective of our target population, younger adults tend to have particularly low hypertension awareness Egan, Zhao, and Axon Health Care Use, Hypertension, and Gender: Conceptual Framework In addition to the biological and behavioral risk factors, there is an open debate regarding the importance of health care—whether access to care or use of care—for hypertension, as well as regarding population health disparities in general. This issue may be particularly salient among young adults, who are more likely to be uninsured and to make fewer doctor visits, especially compared to older adults.
Some work supports the health commodity hypothesis, which posits that health insurance and access to health care in part explain health disparities. Among young adults ages 19—24uninsured persons are more likely to have no contact with a physician or no usual source of care, to delay or miss a medical appointment, and to not fill a prescription because of cost Callahan and Cooper Thus, persons who do not have health insurance are less likely to receive preventive care Freeman et al.