Women and men should take different antihypertensive drugs

Scientists say that another difference between women and men seems to be the key mechanism of how they develop high blood pressure, which determines which antihypertensive drugs are most effective for them

Dr.

Mamanco’s laboratory found evidence in two common human hypertensive rat models.

In men with hypertension, another hormone that regulates blood circulation, angiotensin II, seems to be the main messenger molecule, telling the kidneys to keep blood pressure unchanged

"In hypertension, women are obviously more dependent on aldosterone than men," Mamanko said, using the analogy of opening the same door with your right or left hand

Mamanko recently received a US$1.

If his theory is true, this work will provide a mechanism to explain preclinically why drugs that inhibit aldosterone receptors are effective for some women and are likely to be their preferred treatment options

In fact, the main idea of ​​his project and others further explore various specific causes of high blood pressure, allowing doctors to find the precise blood pressure type of biomarkers in the blood of patients one day, so that they can choose the most suitable current, excessive According to the American Heart Association, 11 drugs, including diuretics, are the oldest classification of aldosterone inhibitor spironolactone

"There are many reasons," Mamenko said

Our body uses the kidneys like a "check valve", expelling more sodium and fluid when blood pressure is high, and retaining them when blood pressure is dangerously low

Mamenko's laboratory has shown that in female hypertensive rats, blocking aldosterone receptors (called mineralocorticoid receptors) can reduce ENaC overactive and unhealthy activities and cause a more significant drop in blood pressure than male rats.

"We know how it happened, and now we want to answer why it happened," Mamanko said

He found that there are more receptors in the kidneys of female hypertensive rats.

One of the many things he is currently studying is whether female mice under normal stress also have more aldosterone receptors

He also treated male hypertensive rats with drugs that prevent the production of angiotensin, and treated female hypertensive rats with aldosterone inhibitors—and vice versa—to see if the theory that females are more aldosterone sensitive
.

Another problem is that under normal circumstances, when the aldosterone level is too high, "aldosterone escape" will happen in just a few weeks, so your sensitivity to hormones will be reduced and blood pressure will drop
.
Mamanko said that this is a fail-safe mechanism that prevents salt and the liquid that comes with it from being absorbed endlessly
.
Therefore, they are studying whether this natural protection is lost in female hypertensive patients, while men continue to be protected, at least not from excessive aldosterone
.

He pointed out that aldosterone sensitivity is not always a bad thing
.
For example, during pregnancy, women rely heavily on aldosterone to maintain increased sodium content to provide additional fluid volume, sufficient amniotic fluid and increased blood volume for mothers and developing babies
.
High levels of the female sex hormone progesterone is the key to body preparation before pregnancy, it can actually produce more aldosterone
.
In fact, high aldosterone levels are usually associated with high progesterone levels
.

Mamenko suspects that this usual production association is "distorted" in high blood pressure.
The ability of aldosterone to promote sodium retention in pregnant women will have an effect on women when blood pressure control is "disrupted
.
"

The other question he wants to answer is whether progesterone increases a woman's response to aldosterone in high blood pressure, including whether it increases the number of aldosterone receptors
.
He thinks the simple answer is "yes", although it may be different
.

Even stranger is that, at least in the kidneys of men, progesterone effectively counteracts the effects of aldosterone: men who take progesterone urinate more frequently
.
But there is also evidence that in women, progesterone can "split" or split in different ways to reduce its blocking effect on aldosterone, and thus produce some products that even work with aldosterone
.

In their research, Mamanko’s laboratory used two models that mimic the types of human hypertension, one of which is that high levels of angiotensin II cause blood pressure to rise, but this is achieved by increasing the secretion of aldosterone.
Yes, the other is a commonly used salt-sensitive hypertension model
.

Physiologists believe that hypertension is a symptom, just like fever, there are various underlying causes, and there is no single solution
.
This is why he wants to help identify people with the same causes, which may be related to gender or diseases, such as adrenal tumors leading to high aldosterone levels, or diabetes, which damages and hardens blood vessel walls
.

He pointed out that the kidney is a key part of identifying diseases, because theoretically (or in reality), you may urinate endless amounts of salt and water, and other methods of lowering blood pressure, such as lowering the heart rate or dilating blood vessels, There are obvious restrictions
.

He also believes that the kidney is likely to be the first place where the usual signal "disruption" occurs, or at least an early place, because high blood pressure requires more fluid, which requires the kidney
.
However, this system can also be destroyed in the blood vessels and brain
.

Hypertension is a major, modifiable risk factor for cardiovascular and kidney disease, Mamenko said
.
According to data from the Centers for Disease Control and Prevention (Centers for Disease Control and Prevention), about half of American adults are considered to have high blood pressure.
The proportion of men suffering from high blood pressure is slightly higher
.

Experts say that treatment options that do not directly address the cause of individual hypertension and non-compliance with the doctor's advice are the reasons for the high rate of stress out of control
.