Author + information
- Received December 18, 2017
- Revision received February 16, 2018
- Accepted February 19, 2018
- Published online April 16, 2018.
- Nanette K. Wenger, MDa,
- Anita Arnold, DO, MBAb,
- C. Noel Bairey Merz, MDc,
- Rhonda M. Cooper-DeHoff, PharmD, MSd,e,
- Keith C. Ferdinand, MDf,
- Jerome L. Fleg, MDg,
- Martha Gulati, MD, MSh,
- Ijeoma Isiadinso, MD, MPHa,
- Dipti Itchhaporia, MDi,
- KellyAnn Light-McGroary, MDj,
- Kathryn J. Lindley, MDk,
- Jennifer H. Mieres, MDl,
- Mary L. Rosser, MD, PhDm,
- George R. Saade, MDn,
- Mary Norine Walsh, MDo and
- Carl J. Pepine, MDe,∗ ()
- aDivision of Cardiology, Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, Georgia
- bLee Health System, Florida State University School of Medicine, Fort Myers, Florida
- cBarbra Streisand Women’s Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California
- dDepartment of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, Florida
- eDivision of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida
- fTulane University Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana
- gDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- hDepartment of Medicine (Cardiology), University of Arizona–Phoenix, Phoenix, Arizona
- iJeffrey M. Carlton Heart & Vascular Institute, Hoag Memorial Hospital Presbyterian, Newport Beach, California
- jDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
- kCardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- lDepartment of Cardiology, Hofstra Northwell School of Medicine, Hempstead, New York
- mDivision of General Obstetrics & Gynecology and Women’s Health, Montefiore Medical Center, Bronx, New York
- nDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
- oHeart Failure and Cardiac Transplantation Program, St. Vincent Heart Center, Indianapolis, Indiana
- ↵∗Address for correspondence:
Dr. Carl J. Pepine, Division of Cardiovascular Medicine, University of Florida College of Medicine, 1600 SW Archer Road, P.O. Box 100277, 1600 SW Archer Road, Gainesville, Florida 32610-0277.
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.
The authors of this work were supported by contracts N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, RO1-HL-073412-01, U0164829, U01 HL649141, and U01 HL649241 from the National Heart, Lung, and Blood Institute (NHLBI); grants from the Gustavus and Louis Pfeiffer Research Foundation, The Women's Guild of Cedars-Sinai Medical Center, The Ladies Hospital Aid Society of Western Pennsylvania, and QMED, Inc. (Laurence Harbor, New Jersey); and by the Edythe L. Broad Endowment, the Barbra Streisand Women's Cardiovascular Research and Education Program, the Linda Joy Pollin Women's Heart Health Program, Cedars-Sinai Medical Center, and the Emory Women's Heart Center, Emory University School of Medicine. The authors of this document are a writing group from the Cardiovascular Disease in Women Committee of the American College of Cardiology. The contents of this paper are solely the responsibility of the authors and do not necessarily reflect the official views of the NHLBI, the National Institutes of Health, or the U.S. Government. Dr. Wenger has served as a consultant for Amgen, AstraZeneca, Gilead Sciences, and Merck; and has received research grants from Alnylam Pharmaceuticals, Gilead Sciences, the NHLBI, Pfizer, and the Society for Women's Health Research. Dr. Bairey Merz has been a consultant for and has received honoraria from the Annenberg Center for Health Science, American Diabetes Association, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study, Expert Exchange, Japanese Circulation Society, Kaiser, Mayo, Northwestern, Pacific Medical Center, Practice Point Communications, Pri-Med, Sanofi, University of Colorado, University of California–San Francisco, University of Utah, Women’s Health Congress, WomenHeart, ACRWH, New York University, San Bernardino, University of California–San Diego, National Institutes of Health Study section service for Cancer, Cardiovascular, Sleep Epidemiology, and the Research Triangle Institute. Dr. Cooper-DeHoff has received funding from the National Institutes of Health Pharmacogenomics Research Network (grant U01-GM074492). Dr. Ferdinand has received grant and/or research support from Boehringer Ingelheim; and has been a consultant for Novartis, Amgen, Sanofi, Boehringer Ingelheim, Eli Lilly, and Quantum Genomics. Dr. Pepine has received grant support from the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine, the National Institutes of Health, National Center for Advancing Translational Sciences—University of Florida Clinical and Translational Science (UL1TR001427), PCORnet-OneFlorida Clinical Research Consortium (CDRN-1501-26692), and the U.S. Department of Defense (CDMRP PR161603); and has received grant support from Adelphi Values, Amgen, AstraZeneca, Athersys, Boehringer Ingelheim, Brigham and Women’s Hospital, Capricor Inc., Cytori Therapeutics, Daiichi-Sankyo, the Department of Defense, Duke University, Gilead Sciences, Inc., inVentive Health Clinical LLC, Merck & Co., National Institutes of Health/NHLBI, Minocycline HTN, Microbiota HTN, Microbiota, Relypsa, and Sanofi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 18, 2017.
- Revision received February 16, 2018.
- Accepted February 19, 2018.
- 2018 American College of Cardiology Foundation
- Central Illustration
- Primary Prevention of Hypertension in Women
- Hypertension in Teenage and Young Adult Women
- Hypertension in Pregnancy
- Treatment of Hypertension in Pregnancy
- Long-Term Implications of Hypertensive Disorders of Pregnancy
- Menopause and Hypertension
- Factors Influencing HTN in Menopause
- Hypertension in Elderly Women
- BP Treatment Benefits: Thresholds, Targets, Agents, Strategies, and Control Rates
- Issues of Race and Ethnicity
- Women in Clinical Trials of Hypertension
- Hypertension in Women: Medication Issues