Xiao Lu, Yang Sicong, Song Yali, Xiao Jia
Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Cardiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Curr Hypertens Rep. 2025 Jun 10;27(1):17. doi: 10.1007/s11906-025-01334-7.
This review provides a critical examination of the sex-specific impact of alcohol consumption on the development and progression of hypertension. Specifically, it elucidates the differential roles of alcohol metabolism and blood pressure regulatory mechanisms in men and women. Finally, it explores promising sex-specific therapeutic strategies for the management of alcoholic hypertension.
Emerging evidence indicates significant sex-based disparities in alcohol pharmacokinetics and pharmacodynamics, with women exhibiting heightened susceptibility to alcohol-induced cardiovascular sequelae. Crucially, key mechanistic insights reveal the differential modulation of the renin-angiotensin-aldosterone system (RAAS), oxidative stress pathways, and the intricate interplay of sex hormones, including the protective effects of estrogen and the potential pro-hypertensive effects of testosterone. Consequently, contemporary therapeutic avenues are increasingly focusing on targeting these sex-specific pathophysiological mechanisms. Alcoholic hypertension manifests with distinct sex-related etiologies and underlying mechanisms, necessitating the development of tailored therapeutic interventions. Effective management strategies should prioritize addressing sex-specific differences in oxidative stress, RAAS activation, and the implementation of personalized lifestyle modifications.
本综述对饮酒对高血压发生和发展的性别特异性影响进行了批判性审视。具体而言,阐明了酒精代谢和血压调节机制在男性和女性中的不同作用。最后,探讨了针对酒精性高血压管理的有前景的性别特异性治疗策略。
新出现的证据表明,酒精的药代动力学和药效学存在显著的性别差异,女性对酒精诱导的心血管后遗症表现出更高的易感性。至关重要的是,关键的机制见解揭示了肾素-血管紧张素-醛固酮系统(RAAS)、氧化应激途径以及性激素复杂相互作用的差异调节,包括雌激素的保护作用和睾酮的潜在促高血压作用。因此,当代治疗途径越来越侧重于针对这些性别特异性病理生理机制。酒精性高血压表现出与性别相关的独特病因和潜在机制,需要制定针对性的治疗干预措施。有效的管理策略应优先解决氧化应激、RAAS激活方面的性别特异性差异,并实施个性化的生活方式改变。