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Lookup NU author(s): Dr Dexter CanoyORCiD
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© 2023 Lippincott Williams and Wilkins. All rights reserved. BACKGROUND: Whether the relative effects of blood pressure (BP)-lowering treatment on cardiovascular outcomes differ by sex, particularly when BP is not substantially elevated, has been uncertain. METHODS: We conducted an individual participant-level data meta-analysis of randomized controlled trials of pharmacological BP lowering. We pooled the data and categorized participants by sex, systolic BP categories in 10-mm Hg increments from <120 to ≥170 mm Hg, and age categories spanning from <55 to ≥85 years. We used fixed-effect one-stage individual participant-level data meta-analyses and applied Cox proportional hazard models, stratified by trial, to analyze the data. RESULTS: We included data from 51 randomized controlled trials involving 358 636 (42% women) participants. Over 4.2 years of median follow-up, a 5-mm Hg reduction in systolic BP decreased the risk of major cardiovascular events both in women and men (hazard ratio [95% CI], 0.92 [0.89-0.95] for women and 0.90 [0.88-0.93] for men; P for interaction, 1). There was no evidence for heterogeneity of relative treatment effects by sex for the major cardiovascular disease, its components, or across the different baseline BP categories (all P for interaction, ≥0.57). The effects in women and men were consistent across age categories and the types of antihypertensive medications (all P for interaction, ≥0.14). CONCLUSIONS: The effects of BP reduction were similar in women and men across all BP and age categories at randomization and with no evidence to suggest that drug classes had differing effects by sex. This study does not substantiate sex-based differences in BP-lowering treatment.
Author(s): Bidel Z, Nazarzadeh M, Canoy D, Copland E, Gerdts E, Woodward M, Gupta AK, Reid CM, Cushman WC, Wachtell K, Teo K, Davis BR, Chalmers J, Pepine CJ, Rahimi K
Publication type: Article
Publication status: Published
Journal: Hypertension
Year: 2023
Volume: 80
Issue: 11
Pages: 2293-2302
Print publication date: 01/11/2023
Online publication date: 24/07/2023
Acceptance date: 02/04/2018
ISSN (print): 0194-911X
ISSN (electronic): 1524-4563
Publisher: Lippincott Williams and Wilkins
URL: https://doi.org/10.1161/HYPERTENSIONAHA.123.21496
DOI: 10.1161/HYPERTENSIONAHA.123.21496
PubMed id: 37485657
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