Hypertension evaluation and management in new young patients: are we doing our female patients a disservice?

Figures & data

Figure 1. Selection and inclusion/exclusion of patients.

Flowchart demonstrating the exclusions made during the analysis based on various criteria such as failure to attend appointments resulting in DNA (Did Not Attend), inaccurate coding as a new patient (NP) and other specified reasons.

Figure 2. Distribution of patients based on gender and first-line drug.

Each bar represents the percentage (%) of males (M) and females (F) given each drug as a percentage of the total first-line drugs given within each male/female category. ACEI, angiotensin-converting enzyme inhibitor, ARB, angiotensin receptor blocker; CCB, calcium channel blocker.

Table 1. Characteristics of new patients under the age of 51 attending hypertension clinic for the first time.

Characteristic	Male mean ± SD (n = 59)	Female mean ± SD (n = 46)
Age at diagnosis (years)	34.8 ± 8.23	33.9 ± 7.58
Age at appointment (years)	37.4 ±8.04	35.6 ±7.65
Systolic BP on referral (mmHg)	165 ± 26.48	154 ± 20.65
Diastolic BP on referral (mmHg)	107 ± 16.73	101 ± 12.61
Systolic BP at new patient appt. (mmHg)	145 ± 19.27	137 ± 19.10
Diastolic BP at new patient appt. (mmHg)	93 ± 15.38	90 ± 10.36
Number of drugs at referral	1.6 ± 1.13	1.3 ±1.0

The demographic characteristics were similar across both sexes. BP, blood pressure.

Table 2. First-line treatment of male and female new patients at time of first attendance at the hypertension clinic.

1st line drug	% of males n = 59	% of females n = 46	p	Total % of whole analysis sample n = 105
ACEi / ARB	44.1	50.0	0.55	46.6
CCB	25	24	1.0	24.8
Beta blocker	5.1	2.2	0.40	3.8
Alpha blocker	0	2.2	0.42	0.95
Thiazide	1.7	2.2	1.0	1.9
Thiazide-like	1.7	0	0.58	0.95
Unclear/unspecified	22.0	19.6	0.81	20.1

ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker.

Table 3. Percentage of male and female patients with treatment deviation from guideline-recommended first line treatment.

	Male (%) n = 59	Female (%) n = 46	p
Deviation from guideline	28.8	34.8	0.45
Clinical explanation for deviation given (as % of deviations)	41.1	37.5	0.71

Table 4. Percentage of male and female patients with secondary hypertension investigations.

Investigation type	Males (%) n = 59	Females (%) n = 46	p
All patients
Blood serum markers	88.1	60.9	<0.001***
Urine biochemistry	39.0	39.1	1
Patients under the age of 40 years
Blood serum markers	87.1	71.0	0.008**
Urine biochemistry	29.4	51.6	0.002**

Table 5. Documentation of female risk factors, family planning (FP) advice and contraception in female patients at the hypertension clinic.

Criteria	Overall female %	Females prescribed an ACEI or ARB %
Obstetric and gynaecological history documented	35.5	34.7
Contraceptive drug history documented	20.0	27.3
FP advice documented	15.6	28.6

Data availability statement

Data will be provided by the corresponding authors upon reasonable request.