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Mechanisms of sex and gender differences in hypertension

Journal of Human Hypertension (2023)Cite this article

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Abstract

The mechanisms that control blood pressure are multifaceted including the sympathetic nervous system and the renin-angiotensin system leading to vasoconstriction and sodium reabsorption that causes a shift in the pressure-natriuesis relationship to higher blood pressures. Sex steroids can affect these mechanisms either directly or indirectly, and the effects may be different depending on the sex of the individual. This review will discuss some of the major blood pressure-controlling mechanisms and how sex steroids may affect them and the need for future studies to better clarify the mechanisms responsible for sex and gender differences in blood pressure control. New mechanisms that are identified, along with what is already known, will provide better tools for treatment of hypertension in men and women of all ethnicities and decrease the risk of cardiovascular disease in the future.

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Fig. 1: Obesity and sympathetic activation.
Fig. 2: Angiotensin mechanisms.
Fig. 3: Potential mechanisms responsible for sex and gender differences in blood pressure control.

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Acknowledgements

This work was supported by the National Institutes of Health (NIH) grants to JFR: R01HL66072, R01HL135089, P01HL051971, P20GM121334, R01AG075963.

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  1. Department of Cell and Molecular Biology, Women’s Health Research Center, Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS, USA

    Jane F. Reckelhoff

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Reckelhoff, J.F. Mechanisms of sex and gender differences in hypertension. J Hum Hypertens (2023). https://doi.org/10.1038/s41371-023-00810-4

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