Hypertension in women

Hypertension in women has received less attention than hypertension in men, and the major controlled trials of antihypertensive therapy have been carr ied out in populations made up predominantly of and have emphasised outcome s in men. Recently it has been recognised that women develop high blood pre ssure, particularly systolic hypertension, at an increased rate as they age , and that this age-related blood pressure increase is exaggerated by the m enopause. The age-related rise in blood pressure, particularly systolic blo od pressure and pulse pressure, contributes substantially to the age-relate d increase in risk of heart attack, heart failure, and stroke in middle-age d and elderly women. This article reviews aspects of hypertension epidemiol ogy, pathophysiology, diagnosis and treatment that are important to women's health with particular emphasis on important concomitant cardiovascular di sease risk factors such as type 2 diabetes and the menopause. The role of o varian hormones and their withdrawal in the pathogenesis of hypertension an d related target organ damage is considered, as are the results of drug tre atment of high blood pressure in women. Blood pressure in pregnancy is disc ussed in a separate article by Broughton-Pipkin and Roberts.