Arterial hypertension in the female world: Pathophysiology and therapy

Journal of Cardiovascular Medicine

Volumn 17, Issue 4, 2016, Pages 229-236

  Cadeddu, Christian ^a   Franconi, Flavia ^b   Cassisa, Laura ^c   Campesi, Ilaria ^b   Pepe, Alessia ^d   Cugusi, Lucia ^a   Maffei, Silvia ^e   Gallina, Sabina ^f   Sciomer, Susanna ^g   Mercuro, Giuseppe ^a  

^a UNIVERSITY OF CAGLIARI   (Italy)

^b UNIVERSITY OF SASSARI   (Italy)

^c Territorial Department of Nephrology and Dialysis   (Italy)

^d Fondazione CNR Regione Toscana G Monasterio   (Italy)

^e INSTITUTE OF CLINICAL PHYSIOLOGY   (Italy)

^f UNIVERSITY OF CHIETI   (Italy)

^g SAPIENZA UNIVERSITY OF ROME   (Italy)

Author keywords

Arterial hypertension; Cardiovascular therapy; Gender medicine

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIHYPERTENSIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; SEX HORMONE;

ARTERIAL STIFFNESS; BLOOD PRESSURE; FEMALE; HEMODYNAMICS; HUMAN; HYPERTENSION; PATHOPHYSIOLOGY; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; REVIEW; SEX DIFFERENCE; SEXUAL FUNCTION; SYMPATHETIC FUNCTION; CARDIOVASCULAR DISEASES; CHEMICALLY INDUCED; COMPLICATION; DRUG UTILIZATION; MALE; PHYSIOLOGY; SEXUAL DEVELOPMENT; SEXUAL DYSFUNCTION; STATISTICS AND NUMERICAL DATA;

ADRENERGIC BETA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; ANTIHYPERTENSIVE AGENTS; CALCIUM CHANNEL BLOCKERS; CARDIOVASCULAR DISEASES; DIURETICS; DRUG UTILIZATION; FEMALE; GONADAL STEROID HORMONES; HUMANS; HYPERTENSION; MALE; SEX CHARACTERISTICS; SEXUAL DYSFUNCTION, PHYSIOLOGICAL;

EID: 84960106866     PISSN: 15582027     EISSN: 15582035     Source Type: Journal    
DOI: 10.2459/JCM.0000000000000315     Document Type: Review

References (120)

1. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics: 2011 update: a report from the American Heart Association. Circulation 2011; 123:e18-e209.
2. Mercuro G, Zoncu S, Dragoni F. Gender differences in cardiovascular risk factors. Ital Heart J 2003; 4:363-366.
3. Rosano GM, Vitale C, Mercuro G. The metabolic syndrome in women. Womens Health (Lond Engl) 2006; 2:889-898.
4. Maas AH, van der Schouw YT, Regitz-Zagrosek V, et al. Red alert for women's heart: the urgent need for more research and knowledge on cardiovascular disease in women: proceedings of the workshop held in Brussels on gender differences in cardiovascular disease, 29 September 2010. Eur Heart J 2011; 32:1362-1368.
5. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women: 2011 update: a guideline from the American Heart Association. Circulation 2011; 123:1243-1262.
6. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360:1903-1913.
7. Plakht Y, Pertzov B, Gez H, Hellerman M, Ifergane G. Stroke hospitalizations over three decades: lower for men, unchanged for women. A population-based study. J Womens Health (Larchmt) 2014; 23:296-301.
8. Engberding N, Wenger NK. Management of hypertension in women. Hypertens Res 2012; 35:251-260.
9. Mercuro G, Zoncu S, Cherchi A, Rosano GM. Can menopause be considered an independent risk factor for cardiovascular disease? Ital Heart J 2001; 2:719-727.
10. Salerni S, Di Francescomarino S, Cadeddu C, Acquistapace F, Maffei S, Gallina S. The different role of sex hormones on female cardiovascular physiology and function: not only oestrogens. Eur J Clin Invest 2015; 45:634-645.
11. Reckelhoff JF. Gender differences in the regulation of blood pressure. Hypertension 2001; 37:1199-1208.
12. Oparil S, Miller AP. Gender and blood pressure. J Clin Hypertens (Greenwich) 2005; 7:300-309.
13. Karpanou EA. ABP changes in menstrual cycle of hypertensive women: data reworked. Am J Hypertension 1995; 6:656.
14. Hilliard LM, Sampson AK, Brown RD, Denton KM. The 'his and hers' of the renin-angiotensin system. Curr Hypertens Rep 2013; 15:71-79.
15. Schulman IH, Aranda P, Raij L, Veronesi M, Aranda FJ, Martin R. Surgical menopause increases salt sensitivity of blood pressure. Hypertension 2006; 47:1168-1174.
16. Mercuro G, Podda A, Pitzalis L, et al. Evidence of a role of endogenous estrogen in the modulation of autonomic nervous system. Am J Cardiol 2000; 85:787-789; A9.
17. Ashraf MS, Vongpatanasin W. Estrogen and hypertension. Curr Hypertens Rep 2006; 8:368-376.
18. Gu Q, Burt VL, Paulose-Ram R, Dillon CF. Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999-2004. Am J Hypertens 2008; 21:789-798.
19. Staessen JA, Thijs L, Wang J, Li Y. Cardiovascular outcomes and antihypertensive drug treatment in older women. J Am Med Assoc 2005; 13:1588.
20. Mercuro G, Zoncu S, Saiu F, Mascia M, Melis GB, Rosano GM. Menopause induced by oophorectomy reveals a role of ovarian estrogen on the maintenance of pressure homeostasis. Maturitas 2004; 47:131-138.
21. Mercuro G, Zoncu S, Piano D, et al. Estradiol-17beta reduces blood pressure and restores the normal amplitude of the circadian blood pressure rhythm in postmenopausal hypertension. Am J Hypertens 1998; 11:909-913.
22. Mercuro G, Zoncu S, Pilia I, Lao A, Melis GB, Cherchi A. Effects of acute administration of transdermal estrogen on postmenopausal women with systemic hypertension. Am J Cardiol 1997; 80:652-655.
23. Mancia G, Fagard R, Narkiewicz K, et al. ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34:2159-2219.
24. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000; 183:S1-S22.
25. Natoli AK, Medley TL, Ahimastos AA, et al. Sex steroids modulate human aortic smooth muscle cell matrix protein deposition and matrix metalloproteinase expression. Hypertension 2005; 46:1129-1134.
26. Campisi D, Cutolo M, Carruba G, et al. Evidence for soluble and nuclear site I binding of estrogens in human aorta. Atherosclerosis 1993; 103:267-277.
27. Ingegno MD, Money SR, Thelmo W, et al. Progesterone receptors in the human heart and great vessels. Lab Invest 1988; 59:353-356.
28. Ahimastos AA, Formosa M, Dart AM, Kingwell BA. Gender differences in large artery stiffness pre and post puberty. J Clin Endocrinol Metab 2003; 88:5375-5380.
29. Williams MR, Westerman RA, Kingwell BA, et al. Variations in endothelial function and arterial compliance during the menstrual cycle. J Clin Endocrinol Metab 2001; 86:5389-5395.
30. Mercuro G, Longu G, Zoncu S, Cherchi A. Impaired forearm blood flow and vasodilator reserve in healthy postmenopausal women. Am Heart J 1999; 137:692-697.
31. Gompel A, Boutouyrie P, Joannides R, et al. Association of menopause and hormone replacement therapy with large artery remodeling. Fertil Steril 2011; 96:1445-1450.
32. Rajkumar C, Kingwell BA, Cameron JD, et al. Hormonal therapy increases arterial compliance in postmenopausal women. J Am Coll Cardiol 1997; 30:350-356.
33. Waddell TK, Rajkumar C, Cameron JD, Jennings GL, Dart AM, Kingwell BA. Withdrawal of hormonal therapy for 4 weeks decreases arterial compliance in postmenopausal women. J Hypertens 1999; 17:413-418.
34. Vitale C, Mercuro G, Cerquetani E, et al. Time since menopause influences the acute and chronic effect of estrogens on endothelial function. Arterioscler Thromb Vasc Biol 2008; 28:348-352.
35. Coutinho T, Borlaug BA, Pellikka PA, Turner ST, Kullo IJ. Sex differences in arterial stiffness and ventricular-arterial interactions. J Am Coll Cardiol 2013; 61:96-103.
36. Mitchell GF, Lacourcière Y, Ouellet JP, et al. Determinants of elevated pulse pressure in middle-aged and older subjects with uncomplicated systolic hypertension: the role of proximal aortic diameter and the aortic pressure-flow relationship. Circulation 2003; 108:1592-1598.
37. Mitchell GF, Parise H, Benjamin EJ, et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. Hypertension 2004; 43:1239-1245.
38. Douglas JG, Bakris GL, Epstein M, et al. Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med 2003; 163:525-541.
39. Regnault V, Thomas F, Safar ME, et al. Sex difference in cardiovascular risk: role of pulse pressure amplification. J Am Coll Cardiol 2012; 59:1771-1777.
40. van den Hoogen PC, Feskens EJ, Nagelkerke NJ, Menotti A, Nissinen A, Kromhout D. The relation between blood pressure and mortality due to coronary heart disease among men in different parts of the world. Seven Countries Study Research Group. N Engl J Med 2000; 342:1-8.
41. Vasan RS, Larson MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 345:1291-1297.
42. Doumas M, Papademetriou V, Faselis C, Kokkinos P. Gender differences in hypertension: myths and reality. Curr Hypertens Rep 2013; 15:321-330.
43. Turnbull F, Woodward M, Neal B, et al. Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials. Eur Heart J 2008; 29:2669-2680.
44. Klungel OH, de Boer A, Paes AH, Seidell JC, Bakker A. Sex differences in antihypertensive drug use: determinants of the choice of medication for hypertension. J Hypertens 1998; 16:1545-1553.
45. Samad Z, Wang TY, Frazier CG, Shah SH, Dolor RJ, Newby LK. Closing the gap: treating hypertension in women. Cardiol Rev 2008; 16:305-313.
46. Erdine S, Arslan E, Olszanecka A. Hypertension in women-pathophysiological and clinical aspects. Przegl Lek 2012; 69:72-75.
47. Wilkins K, Gee M, Campbell N. The difference in hypertension control between older men and women. Health Rep 2012; 23:33-40.
48. Giannattasio C, Cairo M, Cesana F, et al. Blood pressure control in Italian essential hypertensives treated by general practitioners. Am J Hypertens 2012; 25:1182-1187.
49. Mancia G, Zambon A, Soranna D, Merlino L, Corrao G. Factors involved in the discontinuation of antihypertensive drug therapy: an analysis from real life data. J Hypertens 2014; 32:1708-1716.
50. Journath G, Hellénius ML, Carlsson AC, Wändell PE, Nilsson PM, Hyper-Q and Eko Study Groups, Sweden. Physicians' gender is associated with risk factor control in patients on antihypertensive and lipid lowering treatment. Blood Press 2010; 19:240-248.
51. Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation 2008; 117:1028-1036.
52. Kumbhani DJ, Fonarow GC, Cannon CP, et al. Predictors of adherence to performance measures in patients with acute myocardial infarction. Am J Med 2013; 126:74.e1-9.
53. Mazzaglia G, Ambrosioni E, Alacqua M, et al. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation 2009; 120:1598-1605.
54. Holt E, Joyce C, Dornelles A, et al. Sex differences in barriers to antihypertensive medication adherence: findings from the cohort study of medication adherence among older adults. J Am Geriatr Soc 2013; 61:558-564.
55. Doulougou B, Gomez F, Alvarado B, et al. Factors associated with hypertension prevalence, awareness, treatment and control among participants in the International Mobility in Aging Study (IMIAS). J Hum Hypertens 2015; doi: 10.1038/jhh.2015.30. [Epub ahead of print].
56. Brindel P, Hanon O, Dartigues JF, et al. Prevalence, awareness, treatment, and control of hypertension in the elderly: the Three City study. J Hypertens 2006; 24:51-58.
57. Homan SG, McBride DG, Yun S. The effect of the Missouri WISEWOMAN program on control of hypertension, hypercholesterolemia, and elevated blood glucose among low-income women. Prev Chronic Dis 2014; 11:E74.
58. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. J Am Med Assoc 2003; 289:2560-2572.
59. Pimenta E. Hypertension in women. Hypertens Res 2012; 35:148-152.
60. Franconi F, Campesi I. Pharmacogenomics, pharmacokinetics and pharmacodynamics: interaction with biological differences between men and women. Br J Pharmacol 2014; 171:580-594.
61. Franconi F, Campesi I. Sex and gender influences on pharmacological response: an overview. Expert Rev Clin Pharmacol 2014; 7:469-485.
62. Franconi F, Carru C, Malorni W, Vella S, Mercuro G. The effect of sex/gender on cardiovascular pharmacology. Curr Pharm Des 2011; 17:1095-1107.
63. Franconi F, Carru C, Spoletini I, et al. A GENS-based approach to cardiovascular pharmacology: impact on metabolism, pharmacokinetics and pharmacodynamics. Ther Deliv 2011; 2:1437-1453.
64. Cushman WC, Davis BR, Pressel SL, et al. Mortality and morbidity during and after the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. J Clin Hypertens (Greenwich) 2012; 14:20-31.
65. Gueyffier F, Subtil F, Bejan-Angoulvant T, et al. Can we identify response markers to antihypertensive drugs? First results from the Ideal Trial. J Hum Hypertens 2015; 29:22-27.
66. Egom EE, Chirico D, Clark AL. A review of thiazide-induced hyponatraemia. Clin Med 2011; 11:448-451.
67. Rodenburg EM, Hoorn EJ, Ruiter R, et al. Thiazide-associatedhyponatremia: a population-based study. Am J Kidney Dis 2013; 62:67-72.
68. Toner JM, Ramsay LE. Thiazide-induced hypokalaemia; prevalence higher in women. Br J Clin Pharmacol 1984; 18:449-452.
69. Rodenburg EM, Stricker BH, Visser LE. Sex-related differences in hospital admissions attributed to adverse drug reactions in the Netherlands. Br J Clin Pharmacol 2011; 71:95-104.
70. Rodenburg EM, Visser LE, Hoorn EJ, et al. Thiazides and the risk of hypokalemia in the general population. J Hypertens 2014; 32:2092-2097.
71. Franse LV, Pahor M, Di Bari M, et al. Serum uric acid, diuretic treatment and risk of cardiovascular events in the Systolic Hypertension in the Elderly Program (SHEP). J Hypertens 2000; 18:1149-1154.
72. Sowers JR, Bakris GL. Antihypertensive therapy and the risk of type 2 diabetes mellitus. N Engl J Med 2000; 13:969-970.
73. Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Mbewu A, Opie LH. Beta-blockers for hypertension. Cochrane Database Syst Rev 2012; 11:CD002003.
74. De Caterina AR, Leone AM. The role of Beta-blockers as first-line therapy in hypertension. Curr Atheroscler Rep 2011; 13:147-153.
75. Mehvar R, Brocks DR. Stereospecific pharmacokinetics and pharmacodynamics of beta-adrenergic blockers in humans. J Pharm Pharm Sci 2001; 4:185-200.
76. Bijl MJ, Visser LE, van Schaik RH, et al. Genetic variation in the CYP2D6 gene is associated with a lower heart rate and blood pressure in beta-blocker users. Clin Pharmacol Ther 2009; 85:45-50.
77. Lennard MS, Silas JH, Freestone S, Ramsay LE, Tucker GT, Woods HF. Oxidation phenotype: a major determinant of metoprolol metabolism and response. N Engl J Med 1982; 307:1558-1560.
78. Lennard MS, Tucker GT, Woods HF. The polymorphic oxidation of beta-adrenoceptor antagonists. Clinical pharmacokinetic considerations. Clin Pharmacokinet 1986; 11:1-17.
79. Walle UK, Fagan TC, Topmiller MJ, Conradi EC, Walle T. The influence of gender and sex steroid hormones on the plasma binding of propranolol enantiomers. Br J Clin Pharmacol 1994; 37:21-25.
80. Topmiller MJ, Alle T, Fagan TC, et al. The menstrual-cycle does not affect propranolol metabolism. Clin Pharmacol Therapeut 1993; 53:241.
81. Sager G, Nilsen OG, Jacobsen S. Variable binding of propranolol in human serum. Biochem Pharmacol 1979; 28:905-911.
82. Gilmore DA, Gal J, Gerber JG, Nies AS. Age and gender influence the stereoselective pharmacokinetics of propranolol. J Pharmacol Exp Ther 1992; 261:1181-1186.
83. Walle UK, Fagan TC, Topmiller MJ, Conradi EC, Walle T. The influence of gender and sex steroid hormones on the plasma binding of propranolol enantiomers. Br J Clin Pharmacol 1994; 37:21-25.
84. Kneale BJ, Chowienczyk PJ, Brett SE, Coltart DJ, Ritter JM. Gender differences in sensitivity to adrenergic agonists of forearm resistance vasculature. J Am Coll Cardiol 2000; 36:1233-1238.
85. Meredith P. Comparative ARB, pharmacology. Br J Cardiol 2010; 17:s3-s5.
86. Matsui K, Kim-Mitsuyama S, Ogawa H, et al. Sex differences in response to angiotensin II receptor blocker-based therapy in elderly, high-risk, hypertensive Japanese patients: a subanalysis of the OSCAR study. Hypertens Res 2014; 37:526-532.
87. Miller JA, Cherney DZ, Duncan JA, et al. Gender differences in the renal response to renin-angiotensin system blockade. J Am Soc Nephrol 2006; 17:2554-2560.
88. Shekelle PG, Rich MW, Morton SC, et al. Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status: a meta-analysis of major clinical trials. J Am Coll Cardiol 2003; 41:1529-1538.
89. Seeland U, Regitz-Zagrosek V. Sex and gender differences in cardiovascular drug therapy. Handb Exp Pharmacol 2012; 214:211-236.
90. Wing LM, Reid CM, Ryan P, et al. A comparison of outcomes with angiotensin-converting: enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med 2003; 348:583-592.
91. August P, Oparil S. Hypertension in women. J Clin Endocrinol Metab 1999; 84:1862-1866.
92. Jarugula V, Yeh CM, Howard D, Bush C, Keefe DL, Dole WP. Influence of body weight and gender on the pharmacokinetics, pharmacodynamics, and antihypertensive efficacy of aliskiren. J Clin Pharmacol 2010; 50:1358-1366.
93. Fisman EZ, Tenenbaum A, Pines A. Systemic hypertension in postmenopausal women: a clinical approach. Curr Hypertens Rep 2002; 4:464-470.
94. Kloner RA, Sowers JR, DiBona GF, Gaffney M, Wein M. Sex-and age-related antihypertensive effects of amlodipine. The Amlodipine Cardiovascular Community Trial Study Group. Am J Cardiol 1996; 77:713-722.
95. Li CI, Daling JR, Tang MT, Haugen KL, Porter PL, Malone KE. Use of antihypertensive medications and breast cancer risk among women aged 55 to 74 years. J Am Med Assoc Intern Med 2013; 173:1629-1637.
96. Prisant LM, Carr AA, Bottini PB, Solursh DS, Solursh LP. Sexual dysfunction with antihypertensive drugs. Arch Intern Med 1994; 154:730-736.
97. Rosen RC. Sexual dysfunction as an obstacle to compliance with antihypertensive therapy. Blood Press Suppl 1997; 1:47-51.
98. Weinberger MH. Lowering blood pressure in patients without affecting quality of life. Am J Med 1989; 86:94-97.
99. Manolis A, Doumas M. Antihypertensive treatment and sexual dysfunction. Curr Hypertens Rep 2012; 14:285-292.
100. Nicolai MP, Liem SS, Both S, et al. A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice. Neth Heart J 2014; 22:11-19.
101. Brixius K, Middeke M, Lichtenthal A, Jahn E, Schwinger RH. Nitric oxide, erectile dysfunction and beta-blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men. Clin Exp Pharmacol Physiol 2007; 34:327-331.
102. Grimm RH, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five atihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 1997; 29:8-14.
103. Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Report of Medical Research Council Working Party on Mild to Moderate Hypertension. Lancet 1981; 2:539-543.
104. Doumas M, Tsiodras S, Tsakiris A, et al. Female sexual dysfunction in essential hypertension: a common problem being uncovered. J Hypertens 2006; 24:2387-2392.
105. Epstein M, Calhoun DA. Aldosterone blockers (mineralocorticoid receptor antagonism) and potassium-sparing diuretics. J Clin Hypertens (Greenwich) 2011; 13:644-648.
106. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.NEngl J Med 1999; 341:709-717.
107. Fogari R, Zoppi A, Poletti L, Marasi G, Mugellini A, Corradi L. Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study. Am J Hypertens 2001; 14:27-31.
108. Llisterri JL, Lozano Vidal JV, Aznar Vicente J, et al. Sexual dysfunction in hypertensive patients treated with losartan. Am J Med Sci 2001; 321:336-341.
109. Ma R, Yu J, Xu D, et al. Effect of felodipine with irbesartan or metoprolol on sexual function and oxidative stress in women with essential hypertension. J Hypertens 2012; 30:210-216.
110. Fogelman J. Verapamil caused depression, confusion, and impotence. Am J Psychiatry 1988; 3:380.
111. Suzuki H, Tominaga T, Kumagai H, Saruta T. Effects of first-line antihypertensive agents on sexual function and sex hormones. J Hypertens Suppl 1988; 6:S649-S651.
112. Tanner LA, Bosco LA. Gynecomastia associated with calcium channel blocker therapy. Arch Intern Med 1988; 148:379-380.
113. Pitts NE. The clinical evaluation of prazosin, a new antihypertensive agent. Postgrad Med 1975; Spec No:117-127.
114. Grimm RH, Grandits GA, Cutler JA. Relationships of quality-of-life measures to long-term lifestyle and drug treatment in the Treatment of Mild Hypertension Study. Arch Intern Med 1997; 157:638-648.
115. Fogari R, Preti P, Zoppi A, et al. Effect of valsartan and atenolol on sexual behavior in hypertensive postmenopausal women. Am J Hypertens 2004; 17:77-81.
116. Duncan L, Bateman DN. Sexual function in women. Do antihypertensive drugs have an impact? Drug Saf 1993; 8:225-234.
117. Croog SH, Levine S, Sudilovsky A, Baume RM, Clive J. Sexual symptoms in hypertensive patients. A clinical trial of antihypertensive medications. Arch Intern Med 1988; 148:788-794.
118. Leiblum SR, Baume RM, Croog SH. The sexual functioning of elderly hypertensive women. J Sex Marital Ther 1994; 20:259-270.
119. Owens GM. Gender differences in healthcare expenditures, resource utilization, and quality of care. J Manag Care Pharm 2008; 14:2-6.
120. Putting gender on the agenda. Nature 2010; 465:665.