ESOC 2026 | Should there be sex-specific blood pressure targets related to stroke and cognitive decline?

It’s a great question and a challenging one. And I’ll start by saying that our study did not particularly evaluate this exact question. But we did, within our multivariable model, include an interaction term that evaluated for effect modification in the association between cumulative systolic blood pressure and cognitive decline and we actually found there was no effect modification meaning that that association was essentially the same in men and women. However in prior studies you know using different outcomes like incident ischemic stroke there have been different findings so for instance there was a great study by Dr. Madsen using the REGARDS data. And they found that for increasing hypertension severity, that there was almost a twofold increase in the association of incident ischemic stroke in women as compared to men. And so that study would suggest that maybe there is potentially a role for these, you know, sex-specific targets and blood pressure. The challenge is that the studies are rather mixed that exist on this question. And the studies are also largely observational in nature, which has a variety of bias inherent to the study design. One of the issues is that there’s been kind of an under-enrollment historically of women in major cardiovascular and stroke trials. And so I think that that’s a really important future area of research and a priority for the field so that we can get a better, more complete answer to the question that you asked.

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