RICHARD V. LEE, M.D.; GORAN ENHORNING, M.D.
To the editor: Messerli and associates (1) document physiologic differences in mild essential hypertension between men and women, without mentioning the perturbations in cardiovascular physiology unique to women—namely, pregnancy and the syndromes of preeclampsia. Normal gestation decreases peripheral vascular resistance and increases circulating blood volume. Recent reports (2, 3) indicate a role for insulin resistance and hyperinsulinemia in the pathogenesis of essential hypertension. Adipose tissue, greater in women than in men, contributes to insulin resistance. Mammalian pregnancy produces placentally mediated insulin resistance, and pregnancy-associated hypertension is commoner in women with gestational diabetes. However, pregnancy-associated hypertension spontaneously occurs only in bipeds,
LEE RV, ENHORNING G. Essential Hypertension in Men and Women. Ann Intern Med. ;108:148. doi: 10.7326/0003-4819-108-1-148_1
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Published: Ann Intern Med. 1988;108(1):148.
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