Abstract: TH-PO242
Sex Differences in the Risk of Uncontrolled Hypertension: Variation over the Life Course
Session Information
- Hypertension and CVD: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1601 Hypertension and CVD: Basic
Authors
- Yeo, Wan-Jin, NYU Langone Health, New York, New York, United States
- Surapaneni, Aditya L., NYU Langone Health, New York, New York, United States
- Coresh, Josef, Johns Hopkins University, Baltimore, Maryland, United States
- Ballew, Shoshana, Johns Hopkins University, Baltimore, Maryland, United States
- Ozkan, Bige, Johns Hopkins University, Baltimore, Maryland, United States
- Schlosser, Pascal, Johns Hopkins University, Baltimore, Maryland, United States
- Grams, Morgan, NYU Langone Health, New York, New York, United States
Background
Recent studies suggest that sex differences in uncontrolled hypertension (HTN) may vary by age.
Methods
We evaluated the prevalence of HTN and uncontrolled HTN in middle-aged (visit 2) and older-aged (visit 5) men and women of the Atherosclerosis Risk in Communities (ARIC) Study, assessing the associated risk of death and kidney function decline (defined as a 40% decline in eGFR). We looked at whether sex differences in older age could be explained by differences in chronic kidney disease (CKD), coronary heart disease (CHD), obesity, or by anti-HTN medication prescription patterns or adherence.
Results
Among 14,261 participants attending visit 2 (mean age 57), the prevalence of hypertension was 36% in both men and women. Among those with hypertension, the prevalence of uncontrolled hypertension (defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) was higher in men (51%) than in women (44%). Among 6398 participants attending visit 5 (mean age 76), the prevalence of hypertension was similar in both men and women (76% and 74% respectively). Among those with hypertension, the prevalence of uncontrolled hypertension was higher in women (41%) than in men (33%). Both controlled HTN and uncontrolled HTN were risk factors for mortality for visit 2 participants (HR 1.3, 95% CI [0.08, 1.3] and HR 1.5 [1.3, 1.6], respectively), with higher risk associated with uncontrolled HTN in women compared with men (p=6.8E-03). Both controlled HTN and uncontrolled HTN were risk factors for kidney function decline (HR 1.2 [1.0, 1.5] and HR 1.6 [1.4, 1.9], respectively), with no difference by sex. Among visit 5 participants, controlled HTN and uncontrolled HTN were not significantly associated with mortality, but were strong risk factors for kidney function decline (HR 2.1 [1.2, 4.0] and HR 3.4 [1.8, 6.5], respectively) with no sex difference. Differences in uncontrolled HTN by sex at visit 5 was not explained by differences in CKD prevalence, CHD, obesity, anti-HTN medication prescription patterns (prescription, classes, and number), or anti-HTN medication adherence (defined as having at least one detectable anti-HTN medication metabolite in urine).
Conclusion
Uncontrolled HTN shows sex differences which vary by age, with implications for mortality and kidney function decline.
Funding
- NIDDK Support