UC知道7.7 Hypertension in women (Box 18)
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7.7 Hypertension in women (Box 18)
Women typically have lower systolic blood pressure levels than men in the 30-to 44 year age groups [633] .However, systolic blood pressure rises more steeply with age in females than in males [634] which means that at or beyond 60 years of age, women have a higher blood pressure and greater prevalence of hypertension. The continuous relationship between blood pressure and cardiovascular disease is similar in females and males, except for the lower absolute incidence of coronary disease in females before old age[635]. In a meta-analysis of individual patients ,the beneficial effect of antihypertensive treatment versus placebo was found to be similar in the two genders [295]. No gender-based meta-analysis has yet been made of trials comparing different active treatments but most studies have shown similar risk reductions by the various regimens in either gender group, with the exception of the ANBP 2 trial, which reported the benefit of enalapril-
Women typically have lower systolic blood pressure levels than men in the 30-to 44 year age groups [633] .However, systolic blood pressure rises more steeply with age in females than in males [634] which means that at or beyond 60 years of age, women have a higher blood pressure and greater prevalence of hypertension. The continuous relationship between blood pressure and cardiovascular disease is similar in females and males, except for the lower absolute incidence of coronary disease in females before old age[635]. In a meta-analysis of individual patients ,the beneficial effect of antihypertensive treatment versus placebo was found to be similar in the two genders [295]. No gender-based meta-analysis has yet been made of trials comparing different active treatments but most studies have shown similar risk reductions by the various regimens in either gender group, with the exception of the ANBP 2 trial, which reported the benefit of enalapril-
女性的高血压问题
一般来说，在30-44岁的年龄层中，女性的心血管血压要低于男性。然而，随着年龄的增长，女性的心血管血压升高的危险程度要甚于男性，这意味着在60岁以后，女性更加容易患上高血压。血压与心血管疾病之间的关系对于男女而言都类似，不过在年老以前，女性患上心血管病症的机率要低得多。在一份关于个体病例的整合分析当中，抗高血压病类药物治疗与宽心丸在两性当中呈现类似的治疗效果，而想通过多种直接治疗对比试验得出的、基于不同性别的整合分析，目前尚不存在。不过许多科研表明，有两种不同的疗法对于降低两性心血管病风险有着等同的疗效，它们分别是ANBP2实验和VALUE实验。据报道，ANBP2实验是基于苯丁脂脯酸和双氢氯噻嗪两种药物的组合治疗，作用于男性的疗效相对有限。VALUE实验当中的抗高血压药氨氯地平，在降低血压和减少心脏病发病机率方面，比缬沙坦更有疗效，不过只是对于女性而言。
更重要的一项建议是，抗高血压病类药物治疗能够有效避免妇女在育儿期当中，遭受有可能导致胎儿畸形的药物影响。ACE（转换酵素）抗化剂和血管紧缩对抗药应当禁止给受孕女性服用，或者当女性怀孕时立即停止服用。