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Over the last two decades, increasing amounts of research highlight gender differences in regard to heart diseases. Since high blood pressure is a key contributor to cardiovascular diseases, a research paper published in JAMA Cardiology in January 2020 compared blood pressure between men and women.
Based on clinical experience and research studies, heart diseases happen differently in men and women because they have different bodies. This new research paper is based on more than 140,000 blood pressure readings from almost 33,000 people (ages five through 98) taken over a 43 years period.
This study supports previous findings: that high blood pressure starts at an earlier age in men than in women. Women appear to catch up to blood pressure levels in men by midlife. For women, blood pressure starts to rise in the late 30s and shows a steeper rise with aging.
These trends were found to be true for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). During this four-decade-long study, almost 20% of women and 30% of men (about one in four participants) had a cardiovascular event including heart attacks (some fatal), strokes, and heart failure.
Past studies looked at early life differences in blood pressure according to sex. They didn’t observe any from ages five to 14 years. However, higher slopes of both SBP and DBP were noted in males at age 15 years. This correlates with the growth that happens during puberty.
Why Are There Differences?
Scientists want to know why these differences exist. One reason could be hormones. The key contributors to biological sex differences are sex hormones, like the first period, pregnancy, and menopause. Women also have smaller body sizes and smaller organs (including smaller hearts and smaller blood vessels).
Chromosomal factors may play a role. Also, social, economic, and environmental factors mean that there are differences in the lived experience between women and men. This, in turn, can affect cardiovascular function.
Blood Pressure Differences Between Men And Pre-/Post-Menopausal Women
Another study found that men are at greater risk for cardiovascular and kidney diseases in comparison to women of the same age, but only before menopause. After menopause, blood pressure increases in women at a higher rate than men of the same age.
Strangely, hormone replacement therapy in postmenopausal women did not greatly reduce blood pressure. This suggests that estrogen loss may not be the main the only risk factor for high blood pressure.
Women May Have Lower “Normal” Blood Pressure
A 2021 study conducted at Cedars-Sinai Medical Center suggests that women may have a lower “normal” blood pressure range compared to men. Therefore, a one-size-fits-all approach to blood pressure may not be good for women’s health. The research paper showed that a systolic blood pressure of 120 mmHg was the threshold of risk in men. 110 mmHg or lower was the threshold of risk in women. Above these numbers, there was an increased risk for any cardiovascular condition (from heart attacks to heart failure and strokes). It also appears that women’s blood vessels age faster than men’s.
In 2015, the mean blood pressure in the world was 127/79 mmHg in men and a little bit lower than 122/77 mmHg in women, according to a study published in the Lancet. The rate of high blood pressure in the world has increased over the last decades. It went from 594 million in 1975 to 1.13 billion cases in 2019, with the low-income and middle-income countries most affected. Today, roughly one in four men and one in five women have high blood pressure.
Despite gender differences in the age-related risk of high blood pressure, both men and women are now treated in the same way. However, as more research looks into the differences between sexes, future treatments may be geared toward gender.
How To Manage Blood Pressure For Both Men And Women
Whether you are a man or a woman, the best way to manage high blood pressure is to engage in healthy lifestyle choices. Research shows that dietary changes and working out are great ways to lower blood pressure and prevent heart problems.
The DASH diet was designed to manage high blood pressure and works well for most people. This diet significantly reduces SBP by 6.74 mmHg and DBP by 3.54 mmHg.
Working out also helps. Endurance, dynamic resistance, and isometric resistance training are ways to lower both SBP and DBP. Combined training seems to mostly impact DBP.
Many blood-pressure-lowering drugs are on the market. Make sure you visit the doctor often because if your blood pressure isn’t responding, your doctor should adjust your drug or dosage.
