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(Hypertension. 2008;52:787.)
© 2008 American Heart Association, Inc.

Brief Reviews

Neural and Nonneural Mechanisms for Sex Differences in Elderly Hypertension

Can Exercise Training Help?

From the Institute for Exercise and Environmental Medicine (Q.F., B.D.L.), Presbyterian Hospital of Dallas, Tex; and Internal Medicine, Cardiology Division (Q.F., B.D.L.) and Hypertension Division (W.V.), the University of Texas Southwestern Medical Center, Dallas.

Correspondence to Benjamin D. Levine, Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, 7232 Greenville Ave, Suite 435, Dallas, TX 75231. E-mail BenjaminLevine@TexasHealth.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Blood pressure (BP) increases with advancing age in humans in most industrialized societies. The relationship between systolic and diastolic pressures to cardiovascular events is generally more pronounced in people aged 65 years.¹ The Framingham Heart Study and the National Health and Nutrition Examination Survey uniformly demonstrated a higher prevalence of hypertension and a lower BP control rate in elderly women than in men.^2,3 Specifically, only 23% to 28% of hypertensive women over the age of 60 years achieved BP goals on treatment, whereas 36% to 38% of hypertensive men of the same age reached the target BP.² Precise mechanisms for this observation are unknown but may be related to sex differences in the pathophysiology of hypertension or responses to antihypertensive therapy.

It has been recognized that the pathophysiology of hypertension in the elderly is largely attributed to an age-related decline in aortic distensibility resulting in progressive increases in systolic pressure and pulse pressure and a decrease in diastolic pressure.^4,5 However, large epidemiological studies have shown that not only systolic but also diastolic pressure is higher in elderly women than in men, suggesting that other mechanism(s) may contribute to sex differences in BP regulation. For example, one recent study demonstrated that aging was accompanied by a greater increase in sympathetic traffic in healthy women than in men.⁶ It is well known that elevated sympathetic activity plays an important role in the development of hypertension in the young and middle-aged population.^7–10 Whether a sympathetic neural mechanism is responsible for the high prevalence . . . [Full Text of this Article]

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