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Sex, drugs and blood pressure control: the impact of age and gender on sympathetic regulation of arterial pressure

Cardiovascular disease is the leading cause of death in developed countries. Numerous studies confirm that increases in blood pressure occur with ageing, and are associated with an increased risk of cardiovascular events. The effects of ageing on the cardiovascular system and blood pressure control differ between males and females, but the mechanisms underlying this remain unclear (Hart et al. 2009a). Starting in puberty, men tend to have higher blood pressures compared with women; this difference continues until women reach menopause, at which point the incidence of hypertension begins to increase rapidly, often exceeding that of men (Hart et al. 2009a). This has led to the suggestion that female sex hormones exhibit a cardio-protective effect in younger women, although this has not been proven. This article focuses on a recent paper published in The Journal of Physiology by Hart et al. (2011) that illustrates the specific cardiovascular parameters that underlie sex- and age-related differences in sympathetic activity and resting blood pressure. The paper also provides novel mechanistic insight into the role of the sympathetic nervous system in the development of hypertension with age, with a particular emphasis on the effect of menopause on the risk of hypertension in women. We will first examine the findings of this article in context with previous studies in this field, and then provide a thoughtful discussion on the complexity of this article's findings.