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J Am Coll Cardiol. 2018 Apr 24;71(16):1797-1813. doi: 10.1016/j.jacc.2018.02.033.

Hypertension Across a Woman's Life Cycle.

Author information

1
Division of Cardiology, Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, Georgia.
2
Lee Health System, Florida State University School of Medicine, Fort Myers, Florida.
3
Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California.
4
Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, Florida; Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida.
5
Tulane University Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana.
6
Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
7
Department of Medicine (Cardiology), University of Arizona-Phoenix, Phoenix, Arizona.
8
Jeffrey M. Carlton Heart & Vascular Institute, Hoag Memorial Hospital Presbyterian, Newport Beach, California.
9
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa.
10
Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
11
Department of Cardiology, Hofstra Northwell School of Medicine, Hempstead, New York.
12
Division of General Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York.
13
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
14
Heart Failure and Cardiac Transplantation Program, St. Vincent Heart Center, Indianapolis, Indiana.
15
Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida. Electronic address: pepincj@medicine.ufl.edu.

Abstract

Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk factors and management for primary prevention of hypertension in teenage and young adult women; hypertension in pregnancy; hypertension during use of oral contraceptives and assisted reproductive technologies, lactation, menopause, or hormone replacement; hypertension in elderly women; and issues of race and ethnicity. All are detailed in this review, as is information relative to women in clinical trials of hypertension and medication issues. The overarching message is that effective treatment and control of hypertension improves cardiovascular outcomes. But many knowledge gaps persist, including the contribution of hypertensive disorders of pregnancy to cardiovascular disease risk, the role of hormone replacement, blood pressure targets for elderly women, and so on.

KEYWORDS:

hypertension; pregnancy-related hypertension; prevention; race and ethnicity; women

PMID:
29673470
DOI:
10.1016/j.jacc.2018.02.033

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