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Sex differences in antihypertensive drug use and blood pressure control
  1. Junwen Wang,
  2. Weihong Jiang,
  3. Manju Sharma,
  4. Yuyan Wu,
  5. Jiayin Li,
  6. Nana You,
  7. Zewen Ding,
  8. Xiexiong Zhao,
  9. Huilin Chen,
  10. Huiting Tang,
  11. Xiaoyu Zhou,
  12. Xiaogang Li
  1. Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China
  1. Correspondence to Professor Weihong Jiang, Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha 410013, China; jwhxy3{at}


Background Hypertension is the most important modifiable cardiovascular risk factor. Epidemiological studies have shown the benefits of lowering blood pressure (BP), but BP control is a major challenge. Furthermore, there are significant sex differences in antihypertensive drug use and BP control. This study examined sex differences in antihypertensive drug use and BP control, with the aim of reducing the complications of hypertension and improving quality of life.

Methods The study was performed in our outpatient hypertension clinic, and included 1529 patients without secondary hypertension or comorbidities. The study, investigated BP control rates and patterns of antihypertensive drug use in male and female. All data were collected using structured questionnaires and patient measurements.

Results The study included 713 males and 816 females in this study. Fewer females had hypertension in the younger age group (16.2% vs 11.6%; p>0.05), but this difference disappeared in middle-aged (47.8% vs 49.9 %; p<0.05) and elderly age groups (36.0% vs 38.5%; p<0.05). BP control rates differed between males and females (35.6% in male, 31.9% in female, p<0.01). There was an overall difference in BP control rates between males and females (35.6% in males, 31.9% in females, p<0.01). In this aged 18–44 years, angiotensin converting enzyme inhibitors (ACEIs) showed the best control rate in males, while calcium channel blockers (CCBs) were least effective (61.5% with ACEIs, 28.6% with CCBs; p<0.05). In this aged 45–64 years, diuretics (DUs) showed the best control rate in females, while CCBs were least effective (47.5% with DUs, 28.3% with CCBs; p<0.05).

Conclusions Sex plays an important role in BP control. In those aged 18–44 years, males using ACEIs showed best control rates. In those aged 45–64 years, females using DUs showed best control rates. Our study provides a basis with the selection of antihypertensive drugs according to sex and age.

  • sex difference
  • antihypertensive medication
  • blood pressure
  • adults
  • drug prescribing pattern
  • outpatient

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  • Correction notice This article has been corrected since it was published Online First. Author name should read Xiaoyu Zhou, and not Xiaoyu Zhao.

  • Contributors All persons who meet the authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. WJ, MS, JW: study design, data collection, statistical analysis, manuscript writing, proof-reading.

    LX,ZXX, ZXY,DZ, WY, YN: contribution to manuscript. LJ, TH, CH: proof-reading.

  • Funding This study was financially supported by the National Natural Science Foundation of China (NSFC) Projects (No. 81670335 and 81800271).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval An informed consent was taken from all the patients, who were undergone with the approval of the institutional review and ethical committee of Cardiology Department of the Third Xiang Ya Hospital, Central South University. Following ethical approval, permission of the execution of this study was granted.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available in a public, open access repository. There are no data in this work. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.

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