The effect of gender on age-related blood pressure changes and the prevalence of isolated systolic hypertension among older adults: data from NHANES III.

OBJECTIVE: To examine gender differences in age-related blood pressure changes and the prevalence of isolated systolic hypertension. DESIGN: Third National Health and Nutrition Examination Survey, 1988-1994. SETTING: 89 mobile examination centers and household questionnaire. PARTICIPANTS: 6635 men and 7189 women over the age of 18 years who were not under treatment for high blood pressure. MAIN OUTCOME MEASURES: Levels of systolic blood pressure, diastolic blood pressure, and pulse pressure by age and gender; prevalence of isolated systolic hypertension (ISH). RESULTS: Systolic blood pressures (SBP) and pulse pressures (PP) were higher in males than in females among adults less than 45 years old. After age 45, SBP and PP were higher in females. Diastolic blood pressures were lower among adult females across all age categories. The prevalence of stages 1 and 2/3 ISH were higher among females after age 44 years. The magnitude of the gender differences in the prevalence of ISH was also age-dependent. CONCLUSIONS: ISH was higher in elderly women than men. These age-related blood pressure changes may account in part for the higher cardiovascular mortality reported among elderly females compared with elderly males and should be considered an important target for cardiovascular preventive strategy, particularly in elderly females.