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Ambulatory blood pressure monitoring to assess cardiovascular risk in women.

See related article, pp 397–405

Women live longer than men. The longer life expectancy of women is commonly attributed to their lower cardiovascular risk profile and to the fact that they develop cardiovascular complications at a lower rate and a later age than men. A number of population studies have indeed shown that, at comparable age, women are characterized by a lower incidence of angina pectoris, myocardial infarction, and stroke than men.1 This has contributed to the general medical belief that women are at low cardiovascular risk at least until they reach the menopause. One of the issues with this concept is this: do we potentially underestimate the real cardiovascular risk of women and thereby miss an opportunity to improve our ability to prevent cardiovascular complications in women?

In this issue of Hypertension , Boggia et al2 report the results of a comparison of the cardiovascular risk associated with office and ambulatory systolic blood pressure (BP) measurements in a large cohort of women and men from the general population of 11 different countries. As reported previously, women were at lower risk of cardiovascular events than men in this international cohort followed up for a median of 11.2 years. However, when assessing the association of cardiovascular complications with 24-hour ambulatory BP and nighttime BP, the authors found that the relation of all cardiovascular events and stroke and cardiac events with nighttime BP were much steeper in …