Early intervention studies have challenged the notion that lowering blood pressure is beneficial in women with mild
hypertension. In contrast, results of more recent trials have clearly shown that treatment of
hypertension is of benefit in women, particularly in elderly women. Aggressive treatment of
hypertension is advisable in this subset of the population that is exposed to a greater risk of
hypertension-related
cardiovascular diseases because of the greater prevalence of
hypertension and of its inadequate treatment. Hypertensive women are preferentially treated with
diuretics but the rationale for this therapeutic selection is unclear.
Calcium antagonists, beta-blockers and
angiotensin-converting enzyme inhibitors exert an
antihypertensive action similar to that of
diuretics, but their use is limited by the adverse effects that are more frequent in women than in men.
Angiotensin II receptor antagonists, being effective in lowering blood pressure and particularly well tolerated, may represent, in the future, the first-line drugs for treating
hypertension in women.