女性における高血圧 : 診断と治療

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There is no gender difference in the principle of the diagnosis and treatment of hypertension. Hypertension in women is however characterized by its causes of hypertension, relation to obesity, and influences of pregnancy and menopause. Endocrine hypertension such as primary aldosteronism and Cushing' s syndrome is much more common in women than men. Obesity could be more closely correlated to blood pressure increase in women. Special care should be taken in the treatment of hypertension of the pregnant women. Those commonly utilized agents such as angiotensin converting enzyme inhibitors and Ca channel antagonists are basically contraindicated. Difficulties in controlling hypertension are often experienced with hydralazine and a-methyl dopa as the recommended first line agents. Incidence of hypertension is significantly increased in the postmenopausal women. Changes in life style and social circumstance are involved in the development of hypertension in addition to the estrogen deficiency as the major endocrine background. The postmenopausal hypertension has an increasing impact on the quality of life in women because of the significant elongation of the life span. Antihypertensive agents as well as life style modification considering the pathophysiology are needed. Hormone replacement therapy is not recommended solely for the purpose of blood pressure control. Close interrelationship are warranted between internists and obstetricians/gynecologists in any aspects of hypertension in women.
東京女子医科大学の論文
2003-07-25

女性における高血圧 : 診断と治療

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