The Impact of Gender/Sex on Blood Pressure

Men and Women may have differing blood pressures

Does Gender/Sex Affect Blood Pressure?

Gender can have a significant impact on blood pressure (BP), with men and women experiencing different patterns of BP changes over their lifetimes. Understanding
these differences can help healthcare professionals tailor treatment and management strategies for each gender.

One of the most notable differences between men and women when it comes to blood pressure is that women tend to have lower blood pressure than men. According to the AHA, women typically have a systolic pressure that is about 5 mmHg lower than men, and a diastolic pressure that is about 10 mmHg lower than men. This means that women are less likely to develop hypertension (high blood pressure), which is a major risk factor for cardiovascular disease.

One reason for the difference in blood pressure between men and women may be related to differences in body size and composition. Men are generally larger and have more muscle mass than women, which means they require more blood flow to supply oxygen and nutrients to their tissues. This increased demand for blood flow can lead to higher blood pressure. In contrast, women have smaller and more elastic blood vessels than men, which can help to reduce resistance to blood flow and lower blood pressure.


Another factor that may contribute to the difference in blood pressure between men and women is the influence of sex hormones. Research has shown that estrogen, which is the primary female sex hormone, can have a protective effect on blood vessels and help to lower blood pressure. Estrogen has been shown to increase the production of nitric oxide, a molecule that helps to relax blood vessels and improve blood flow. In addition, estrogen has been shown to reduce the activity of the renin-angiotensin-aldosterone system (RAAS), which is a hormone system that regulates blood pressure.

However, the protective effects of estrogen on blood pressure may be offset by the effects of progesterone, which is another female sex hormone. Progesterone has been shown to increase blood pressure by promoting sodium retention and vasoconstriction (narrowing of blood vessels). Therefore, changes in estrogen and progesterone levels during the menstrual cycle, pregnancy, and menopause may contribute to fluctuations in blood pressure in women.

  • Pregnancy: During pregnancy, the body produces more blood to support the developing fetus. This extra blood puts pressure on the blood vessels, which can cause blood pressure to increase. Additionally, some women may develop gestational hypertension, which is high blood pressure that develops during pregnancy and usually goes away after delivery. If left untreated, gestational hypertension can lead to complications for both the mother and baby.

  • Oral contraceptive use: Some types of oral contraceptives contain hormones that can raise blood pressure levels. This is more likely to occur in women who already have high blood pressure, are overweight, or smoke. Women who are taking oral contraceptives should have their blood pressure checked regularly.

  • Menopause: The hormonal changes that occur during menopause can also affect blood pressure. As estrogen levels decline, blood vessels can become stiffer, which can increase blood pressure levels. Additionally, menopausal women may experience weight gain and changes in physical activity levels, which can also contribute to high blood pressure.

  • Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder that affects women of reproductive age. Women with PCOS are more likely to develop high blood pressure, as well as other conditions such as diabetes and high cholesterol. The exact reasons for this are not fully understood, but it is thought to be related to the hormonal imbalances that occur with PCOS.


Men are more likely to develop hypertension at a younger age than women. This is partly due to lifestyle factors, such as smoking and drinking, which are more prevalent among men. Men are also more likely to be overweight and have a higher body mass index (BMI) than women, which is another risk factor for hypertension.

Social and environmental factors may also contribute to the disparities in hypertension risk between men and women. Men may experience more work-related stress and have less social support, both of which can contribute to higher blood pressure. Additionally, men may be less likely to seek medical care or take medication for hypertension, which can exacerbate the condition.


Another factor that may contribute to the differences in blood pressure between men and women is genetics. Studies have shown that certain genes may be more strongly associated with blood pressure in men than in women. For example, the ACE gene, which regulates blood pressure, has been shown to have a greater impact on blood pressure in men than in women.


Management strategies for high BP should take these gender differences into account. For example, healthcare professionals may need to adjust medication dosages or types based on a patient's gender and hormonal status. Lifestyle changes such as weight loss, healthy eating, and regular physical activity can also help manage BP in both men and women.