Abstract：
UNASSIGNED: Cardiovascular disease (CVD) is one of the leading causes of death in women, largely underpinned by hypertension. Current guidelines recommend first-line therapy with a RAAS-blocking agent especially in young people. There are well documented sex disparities in CVD outcomes and management. We evaluate the management of patients with newly diagnosed hypertension in a tertiary care clinic to assess male-female differences in investigation and treatment.
UNASSIGNED: Clinic letters of all new patients under the age of 51 attending the Glasgow Blood Pressure Clinic between January and December 2023 were reviewed. The primary outcomes measured were first-line treatment choices, deviations from guideline-recommended treatment, investigations for secondary hypertension, and documentation of female-specific risk factors and family planning advice. Secondary outcomes included clinical characteristics such as systolic and diastolic blood pressure at referral and at the new patient appointment, age at diagnosis, age at first appointment, and the number of antihypertensive drugs prescribed at referral.
UNASSIGNED: One hundred and five (59:46, M:F) new patient encounters were reviewed after sixteen exclusions for non-attendance and inappropriate clinic coding. Choice of first line antihypertensive agent did not vary between sexes with no deviation from guideline-recommended medical therapy. Men, however, had more biochemical investigations conducted for secondary causes across all ages. This was greatest in those under 40 years old. There was suboptimal documentation of female-specific risk factors (obstetric and gynaecological history), contraceptive drug history and family planning with 35%, 20%, and 15.6%, respectively.
UNASSIGNED: In 2023, women under 51 years of age seen in a tertiary care hypertension clinic received similar first-line treatment to their male peers. However, relevant female-specific histories were suboptimally documented for these patients. Whilst therapeutic approaches in men and women appear to be similar in this clinic, there are opportunities to improve CVD prevention in women, even in a specialised clinic setting.
Hypertension, or persistent high blood pressure, is a condition that can lead to serious cardiovascular diseases such as stroke and heart failure. Evidence has shown that women have cardiovascular disease more than men and it is the leading cause of death in women in Europe. To understand how male and female patients are treated for hypertension, we examined documented consultations and treatments of 105 patients under the age of 51 (46 women and 59 men) at a Glasgow hypertension clinic in 2023. We found that men had more investigations for specific causes of their hypertension across all ages (men = 88%, women = 61%). Recording of reproductive history (35%), contraceptive drug history (20%) and advice on family planning (15.6%) was not as thorough as they could be. Incorrect management of female reproductive history and contraceptive drug history can increase the risk of long-term hypertension complications, so managing this is crucial. A class of drugs commonly used to manage hypertension called RAAS blockers are dangerous to the foetus when pregnant - another factor to consider when managing young women with high blood pressure. Overall, these findings mean that there may be a need for more thorough consideration of women’s health factors in hypertension treatment. By paying attention to these areas, we can enhance long-term cardiovascular health for women.
UNASSIGNED: Clinic letters of all new patients under the age of 51 attending the Glasgow Blood Pressure Clinic between January and December 2023 were reviewed. The primary outcomes measured were first-line treatment choices, deviations from guideline-recommended treatment, investigations for secondary hypertension, and documentation of female-specific risk factors and family planning advice. Secondary outcomes included clinical characteristics such as systolic and diastolic blood pressure at referral and at the new patient appointment, age at diagnosis, age at first appointment, and the number of antihypertensive drugs prescribed at referral.
UNASSIGNED: One hundred and five (59:46, M:F) new patient encounters were reviewed after sixteen exclusions for non-attendance and inappropriate clinic coding. Choice of first line antihypertensive agent did not vary between sexes with no deviation from guideline-recommended medical therapy. Men, however, had more biochemical investigations conducted for secondary causes across all ages. This was greatest in those under 40 years old. There was suboptimal documentation of female-specific risk factors (obstetric and gynaecological history), contraceptive drug history and family planning with 35%, 20%, and 15.6%, respectively.
UNASSIGNED: In 2023, women under 51 years of age seen in a tertiary care hypertension clinic received similar first-line treatment to their male peers. However, relevant female-specific histories were suboptimally documented for these patients. Whilst therapeutic approaches in men and women appear to be similar in this clinic, there are opportunities to improve CVD prevention in women, even in a specialised clinic setting.
Hypertension, or persistent high blood pressure, is a condition that can lead to serious cardiovascular diseases such as stroke and heart failure. Evidence has shown that women have cardiovascular disease more than men and it is the leading cause of death in women in Europe. To understand how male and female patients are treated for hypertension, we examined documented consultations and treatments of 105 patients under the age of 51 (46 women and 59 men) at a Glasgow hypertension clinic in 2023. We found that men had more investigations for specific causes of their hypertension across all ages (men = 88%, women = 61%). Recording of reproductive history (35%), contraceptive drug history (20%) and advice on family planning (15.6%) was not as thorough as they could be. Incorrect management of female reproductive history and contraceptive drug history can increase the risk of long-term hypertension complications, so managing this is crucial. A class of drugs commonly used to manage hypertension called RAAS blockers are dangerous to the foetus when pregnant - another factor to consider when managing young women with high blood pressure. Overall, these findings mean that there may be a need for more thorough consideration of women’s health factors in hypertension treatment. By paying attention to these areas, we can enhance long-term cardiovascular health for women.
摘要：
心血管疾病（CVD）是女性死亡的主要原因之一，很大程度上是由高血压支撑的。目前的指南建议使用RAAS阻断剂进行一线治疗，尤其是在年轻人中。在CVD结果和管理方面存在有据可查的性别差异。我们评估了三级护理诊所中新诊断的高血压患者的管理，以评估调查和治疗中的男女差异。
■审查了2023年1月至12月期间在格拉斯哥血压诊所就诊的所有51岁以下新患者的诊所信件。测量的主要结果是一线治疗选择，偏离指南推荐的治疗，继发性高血压的调查，以及记录女性特有的危险因素和计划生育建议。次要结局包括临床特征，如转诊时和新患者预约时的收缩压和舒张压，诊断时的年龄，第一次预约的年龄，以及转诊时处方的降压药数量。
■在16例因不就诊和不适当的临床编码而被排除后，对105例（59：46，M：F）新患者的情况进行了审查。一线抗高血压药的选择在性别之间没有差异，并且没有偏离指南推荐的药物治疗。男人,然而,对所有年龄段的次要原因进行了更多的生化研究。这在40岁以下的人群中是最大的。女性特定的危险因素（产科和妇科病史）的记录欠佳，避孕药物史和计划生育占35%，20%,和15.6%，分别。
■2023年，在三级护理高血压诊所中看到的51岁以下的女性接受了与男性同龄人相似的一线治疗。然而,对于这些患者,相关女性病史的记录并不理想.虽然在这个诊所中男性和女性的治疗方法似乎相似，有机会改善女性的心血管疾病预防，即使是在专门的诊所。
高血压,或者持续的高血压,是一种可能导致中风和心力衰竭等严重心血管疾病的疾病。有证据表明，女性患心血管疾病的人数多于男性，是欧洲女性死亡的主要原因。为了了解男性和女性患者是如何治疗高血压的，我们在2023年对格拉斯哥高血压诊所的105例51岁以下患者(46例女性和59例男性)的咨询和治疗记录进行了检查.我们发现，男性对所有年龄段的高血压的具体原因进行了更多的调查(男性=88%，女性=61%)。记录生殖史（35％），避孕药物史（20％）和计划生育建议（15.6％）没有那么彻底。对女性生殖史和避孕药物史的不正确管理会增加长期高血压并发症的风险，所以管理这个是至关重要的。一类常用于治疗高血压的药物称为RAAS阻滞剂，在怀孕时对胎儿是危险的，这是在治疗年轻女性高血压时要考虑的另一个因素。总的来说,这些发现意味着在高血压治疗中可能需要更全面地考虑女性的健康因素.通过关注这些领域，我们可以增强女性的长期心血管健康。
■审查了2023年1月至12月期间在格拉斯哥血压诊所就诊的所有51岁以下新患者的诊所信件。测量的主要结果是一线治疗选择，偏离指南推荐的治疗，继发性高血压的调查，以及记录女性特有的危险因素和计划生育建议。次要结局包括临床特征，如转诊时和新患者预约时的收缩压和舒张压，诊断时的年龄，第一次预约的年龄，以及转诊时处方的降压药数量。
■在16例因不就诊和不适当的临床编码而被排除后，对105例（59：46，M：F）新患者的情况进行了审查。一线抗高血压药的选择在性别之间没有差异，并且没有偏离指南推荐的药物治疗。男人,然而,对所有年龄段的次要原因进行了更多的生化研究。这在40岁以下的人群中是最大的。女性特定的危险因素（产科和妇科病史）的记录欠佳，避孕药物史和计划生育占35%，20%,和15.6%，分别。
■2023年，在三级护理高血压诊所中看到的51岁以下的女性接受了与男性同龄人相似的一线治疗。然而,对于这些患者,相关女性病史的记录并不理想.虽然在这个诊所中男性和女性的治疗方法似乎相似，有机会改善女性的心血管疾病预防，即使是在专门的诊所。
高血压,或者持续的高血压,是一种可能导致中风和心力衰竭等严重心血管疾病的疾病。有证据表明，女性患心血管疾病的人数多于男性，是欧洲女性死亡的主要原因。为了了解男性和女性患者是如何治疗高血压的，我们在2023年对格拉斯哥高血压诊所的105例51岁以下患者(46例女性和59例男性)的咨询和治疗记录进行了检查.我们发现，男性对所有年龄段的高血压的具体原因进行了更多的调查(男性=88%，女性=61%)。记录生殖史（35％），避孕药物史（20％）和计划生育建议（15.6％）没有那么彻底。对女性生殖史和避孕药物史的不正确管理会增加长期高血压并发症的风险，所以管理这个是至关重要的。一类常用于治疗高血压的药物称为RAAS阻滞剂，在怀孕时对胎儿是危险的，这是在治疗年轻女性高血压时要考虑的另一个因素。总的来说,这些发现意味着在高血压治疗中可能需要更全面地考虑女性的健康因素.通过关注这些领域，我们可以增强女性的长期心血管健康。
