Comparison of clinical outcomes between genders following antihypertensive therapy: A meta-analysis

Background: Numerous studies have reported sex and gender differences in the prevalence and treatment of cardiovascular diseases. However, sex differences in the therapy of hypertension have not been completely examined. Objective: To estimate the gender-specific dissimilarity in outcomes among patients following antihypertensive treatment, using a meta-analysis of available studies. Methods: A systematic literature search in Medline and SCOPUS databases was performed from January 1990 to January 2015 to find studies assessing clinical outcomes in male and female subjects after hypertension treatment, separately. Quantitative data synthesis was performed using a random-effects model, with weighed mean difference (WMD) and 95% confidence interval (CI) as summary statistics. Results: The analysis included 10 studies with 16 treatment arms. Outcomes were found to be significantly more frequent in men then in women (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.17, 1.33, p < 0.001; I2:40.17%), and this result was robust and independent. Random-effects meta-regression showed no association of outcomes with treatment duration and baseline levels. Conclusion: The present meta-analysis demonstrates that clinical outcomes are more frequent in men compared with women after the same treatment of hypertension. Numerous reasons, including disparities in compliance, age, and intrinsic higher risk in male, contribute to justify these findings.