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A15360 The gender differences of blood pressure management and antihypertensive therapy in aged generation

Objectives: Gender difference of blood pressure (BP) becomes smaller later in life. The prescription rate of antihypertensive drug classes and therapeutic responses may differ by gender, but gender differences of hypertension management in the postmenopausal age group are not clear. To clarify in elderly population if the rate of antihypertensive drug prescription and treated BP levels differ by gender. This retrospective, cross-sectional study analyzed 449 essential hypertensive patients over the age of 60 at Tokyo Women's Medical University Hospital Hypertension Clinic from April 2014 to March 2015. Methods: Office BP and anthropometric data were collected, and Defined Daily Dose (DDD) of antihypertensive drugs were calculated as defined by the World Health Organization. Results: Of all subjects (180 men and 269 women), 71% were on calcium channel blocker (CCB), and 63% were on renin-angiotensin system inhibitors (RAASi) including mineralocorticoid receptor blockers and direct renin inhibitor. There was no significant gender difference in systolic BP (SBP), diastolic BP (DBP), body mass index (BMI), total DDD. While there was no gender difference in SBP by drug class, DBP was significantly lower in women than men taking CCB (74.1 mmHg vs. 76.7 mmHg, 213 women, 144 men, p = 0.025) and also RAASi (73.7 mmHg vs. 76.7 mmHg, 167 women, 138 men, p = 0.019). DBP of obese (BMI > 25) men was significantly higher than obese women (74.0 mmHg vs. 79.7 mmHg, 55 women, 55 men, p = 0.004). Conclusion: In elderly essential hypertensive patients, there was no gender difference in BP level or medication dose except the DBP in those taking CCB, RAASi or with obesity. Elderly men may need more CCB and/or RAASi than women to control BP.