Hypertension and gender: Pathophysiology and treatment of gender differences in hypertension

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<ul><li><p>GENDER MEDICINE </p><p>betes is associated. Black and Hispanic men with MI-diabetes have the lowest smoking cessation counseling rates (16%; 13%). Gender comparisons in both CHF and CHF-hypertension/ ESRD show white women less likely to have LVF assessment. Hispanics were least likely to have LVF assessment, even if they have diabetes. Hispanics have lower rates of ACE inhibitor therapy, even if they have combined CHF-hypertension/ ESRD. Conclus ions: Gender and race/ettmicity differences exist in management of MI/CHE Having diabetes or hypertension/ ESRD associated to MI/CHF does not imply better quality care. Cardiovascular care must target gender-specific needs across race/ethnicity. </p><p>F1.09 14:30-15:00, Friday, February 24, 2006 Migraines--A Feminine Disease Rafael L. Carasso Department of Neurology and Pain Clinic, Hillel Yaffe Medical Center, Hadera, Israel; Department ofl Psychology, Bar Ilan University Ramat-Gan, Israel; Rapoport School ofl Medicine, Technion Haifla, Israel; and College ofl Management, Academic Studies Division, Rishon Le-Zion, Israel The overall prevalence of migraine in the western world is approximately 10%, affecting only 6% of men and 18% of women. Migraine headache can affect the psychologic well-being of women suffering from this brain neuro- vascular disease leaving them depressed, angry, tearful, and frustrated. Migraine not only prevents women from enjoy- ing life to the fullest, but can have a devastating impact on their well-being and self-worth, which can negatively affect all other aspects of women's lives. Can it be said that mi- graine is a women's disease only because it affects three times more women than men? Is there a genetic compo- nent? Many attacks appear in proximity to the month ly period, and most of them disappear during the second and third trimester of pregnancy. What is the role of the femi- nine hormones and how to treat migraine? </p><p>F1.10 15:00-15:30, Friday, February 24, 2006 Hypertension and Gender: Pathophysiology and Treatment of Gender Differences in Hypertension Ingrid Os University of Oslo, Department of Nephrology, Ulleval, University Hospital, Oslo, Norway Epidemiological evidence suggests gender differences in prevalence and blood pressure levels in the different age groups. The difference in blood pressure and the fluctuation with age is not known; however, sex hormones have been implicated. There is no clear-cut gender differences in the pathophysiology of essential hypertension. On the other hand, the renin-angiotensin-system exhibits differences that could be of clinical importance, and gender also appears to be an important determinant of autonomic function mea- sured as baroreflex sensitivity and heart rate variability. Plasma renin activity is reported to be lower in hypertensive women compared to hypertensive men as well as to nor- motensive women. Obesity is an important contributor to hypertension in females, and psychosocial aspects may affect blood pressure levels differently in men and women. Furthermore, there is disparate cardiovascular findings in men and women, and hypertensive target organ damage </p><p>$18 </p><p>may also differ. In general, the antihypertensive efficacy of pharmacological agents is similar for both sexes; however, the prescription pattern differs. The recommendat ion for non-pharmacological t reatment is similar for men and women; however, the effect of such treatment has not been extensively studied from a gender perspective. Some side effects of antihypertensive drags are more pronounced in women, ie, ACE-induced cough, but there is little data on other side effects, including sexual dysfunction in female hypertensive subjects. Hypertension is an important risk fac- tor for cardiovascular and renal disease in women despite differences in pathophysiology and treatment approach. More studies are needed to look at interactions between gen- der and treatment effects as well as gender and genotypes. </p><p>F1.11 15:30-16:00, Friday, February 24, 2006 Renal Disease in Men and Women: What Protects Women and Makes Men Vulnerable? Kathryn Sandberg; and Hong Ji Georgetown University, Washington, DC, USA In many types of kidney disease, including chronic renal disease, polycystic kidney disease, membranous nephropa- thy, and immunoglobin A nephropathy, renal disease pro- gression is faster in men than women. This sex difference in renal disease progression is also observed in a wide variety of animal models. This presentat ion will focus on the clini- cal and experimental studies that have investigated these sex differences. The role of blood pressure, serum lipids, renal structure and function, the renin angiotensin system, gonadal steroid hormone action, as well as oxidative stress and inflammatory pathways in female protection and male vulnerability to progressive renal disease, will all be ad- dressed. Understanding the mechanisms underlying the sex differences in renal disease progression will facilitate the de- velopment of new therapeutics for the t reatment of chron- ic kidney and end stage renal disease in both sexes. </p><p>F1.14 17:30-18:00, Friday, February 24, 2006 Gender, Sex, and Chronic Pain-Clinkal Aspects Linda LeResche University of Washington, Seattle, WA, USA Epidemiologic studies indicate that most pain conditions are more common in women than in men. However, the differing age patterns for different pain conditions suggest sex and gender interact with other factors to influence rates of onset or persistence for specific pain conditions. There are a variety of reasons why particular chronic pain condi- tions may be more prevalent in women. Viewed within the context of a multidimensional, biopsychosocial model of chronic pain, sex (biological identity associated with chro- mosomes) and/or gender (psychosocial/role identity) can influence the experience of chronic pain at many different levels. There is growing evidence for anatomical and neuro- physiological differences in the nociceptive systems of males and females: sex differences in perceptual sensitivity have been documented within a number of sensory sys- tems; stress response, emotional reactions and pain coping differ by gender; pain behavior is influenced by socializa- tion and gender roles; and differing social and cultural roles for males and females are associated with exposures to dif- ferent risk factors for pain, as well as with differing expecta- </p></li></ul>

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