Women are Different!: Gender Specific Protocols for Treatment of Hypertension

Tuesday, 23 July 2013: 1:30 PM

Rebecca J. Whiffen, DNP, MSN, FNP-BC, ACNP-BC
College of Nursing, Southeast Hospital College of Nursing and Health Sciences, Cape Girardeau, MO

Learning Objective 1: The learner will be able to recognize the disparities and differences in research, practice guidelines and treatment of hypertension in women.

Learning Objective 2: The learner will be able to understand and apply the gender specific protocols to their own practice.


This study has dual, complementing purposes: first, a comprehensive literature review of reported gender, race, age and menopausal status variables in the treatment of hypertension in women, and second, an evaluation of hypertension treatment for best practices.  These data were then compiled and utilized to propose a gender specific protocol for treatment of hypertension.


A retrospective chart review of 100 women with the diagnosis of benign hypertension was performed in a large cardiovascular practice.  Patient charts were reviewed to identify the antihypertensive medications currently in use, and the data were compared for best practices by using the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) (Chobanian, 2003), and The Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women 2011 Update (Mosca, 2011).


When evaluating the evidence for  best practices, these data show that out of the 100 women, 76% were found to have controlled hypertension (BP < 140/90), as compared to the national rate of 64% (CDC, 2005).  The most common medications used in this practice were Beta Blockers, ACE Inhibitors, Angiotensin II Receptor Blockers, Calcium Channel Blockers, Alpha Blockers and Diuretics.  Out of the 33 women who had the diagnosis of diabetes mellitus (DM), 54% were on an angiotensin converting enzyme inhibitor (ACE) or angiotensin receptor blocker (ARB), as recommended by JNC 7(Chobanian, 2003).  Gender specific protocols were developed using these data as well as the research material.


The protocols developed are gender specific, with recommendations for the variables of age, race, menopausal status, and presence of co-morbidities.  These protocols could easily streamline a treatment plan for new practitioners and also give women a voice in what current evidence shows is best practice in the treatment of hypertension.