High Blood Pressure and PCOS

pcos blood pressure
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Women with polycystic ovary syndrome (PCOS) can add hypertension to the long list of metabolic complications they are at high risk for. Referred to as “the silent killer” for its mostly absent warning signs, hypertension (high blood pressure) is a condition not to be taken lightly.

Data obtained from the Dallas Heart Study showed that when women with PCOS were compared to women without the condition, those with PCOS showed a higher prevalence of high blood pressure, regardless of race or ethnicity.

If not controlled, high blood pressure can damage blood vessels and organs. Complications of high blood pressure include vision problems, kidney damage, or even a heart attack or stroke. Knowing and reducing your risk factors (see below), can help you minimize your risk.

Risk Factors for High Blood Pressure

There are many risk factors for having high blood pressure. These include:

  • Consuming a diet high in sodium (salt)
  • Being a smoker
  • Lack of physical activity
  • Being overweight
  • Increased age
  • Being African American
  • Stress
  • Insulin resistance
  • Family history
  • Depression
  • Excessive alcohol consumption
  • Having other medical conditions such as high cholesterol or type 2 diabetes

Measuring Blood Pressure

Blood pressure is measured by using a blood pressure cuff. A trained health care provider will also use a stethoscope to determine two separate blood pressure readings. The first is listening for the “top” number, or systolic.

This indicates your heart beating. The second number is the diastolic reading or “bottom number,” which is determining the blood pressure when the heart rests between beats. An electronic device can also be used at home to monitor blood pressure.

If the measurement reads 110 systolic and 70 diastolic, you would hear "110 over 70" or write "110/70 mmHg."

Diagnosing Hypertension

Your blood pressure levels (systolic and diastolic) determine if you have normal or elevated blood pressure. Here are the cutoff levels according to the Center for Disease Control:

Normal:

Systolic: less than 120 mmHg

Diastolic: less than 80mmHg

At risk (prehypertension):

Systolic: 120–139 mmHg

Diastolic: 80–89 mmHg

High blood pressure:

Systolic: 140 mmHg or higher

Diastolic: 90 mmHg or higher

Blood pressure readings greater than 180/110 are considered a hypertensive crisis, requiring medical treatment.

Preventing High Blood Pressure

Preventing high blood pressure starts with living a healthy lifestyle. Maintaining your weight, following a healthy diet, and exercising routinely are all actions that you can take now to reduce your chances of having high blood pressure.

Treating High Blood Pressure

What you eat plays a significant role in managing your blood pressure. Losing weight, decreasing alcohol and increasing exercise are lifestyle changes that can lower your blood pressure. In addition, here are some changes you can make in your diet to reduce your blood pressure.

Eat Less Salt

Most Americans eat way more sodium than what’s recommended. Americans should be eating no more than 1,500 mg a day (that’s just a little over half a teaspoon of salt!) according to the American Heart Association.

It’s not unusual for a restaurant meal to contain a days’ worth of sodium.

Besides eating out, the main sources of sodium are prepared meals, frozen meals, canned foods, and of course, using the salt shaker. Reading food labels and cooking more meals at home where you control the salt amount can make a difference.

Add More Fruits and Vegetables

Yes, there really is a reason to eat your fruits and vegetables: they help lower blood pressure. Fruits and vegetables contain nutrients such as magnesium, calcium, and potassium, which work to counteract the effects of high sodium in our bodies.

The DASH (Dietary Approaches to Stop Hypertension) Diet is proof that fruits and vegetables help to reduce blood pressure in women with PCOS.

Women with PCOS who followed the DASH diet saw significant improvements to their blood pressure, as well as abdominal fat loss. Significant improvements in insulin resistance and inflammation markers were also shown.

The DASH diet recommends 4 to 5 servings each day of both fruits and vegetables.

Emphasizes Nuts, Seeds, and Legumes

The DASH diet is plant-based with an emphasis on including 4 to 5 servings a week of a variety of nuts, seeds, and legumes (lentils and peas). Not only do these foods provide a good source of fiber, but also contain magnesium and potassium to lower blood pressure.

Don’t Forget the Fat!

Omega-3 fatty acids like those found in fatty fish, nuts, avocados, and olive oil have a blood pressure lowering effect. A study published in the American Journal of Hypertension compared a diet of polyphenol-rich olive oil to a diet that didn't contain any polyphenols and their effects on blood pressure in young women. After four months, the olive oil group was linked with decreases in systolic and diastolic blood pressure.

Medications to Treat High Blood Pressure

If diet and lifestyle interventions are not effective, or if you are still having high blood pressure, your physician can prescribe anti-hypertensive medications to help you control it.

Many different types of medications can be used including diuretics, calcium channel blockers, ACE inhibitors, or beta blockers.

Diuretics

Diuretics excrete excess salt and water from the body, helping to lower blood pressure. Spironolactone, for example, is a potassium-sparing diuretic commonly used in women with PCOS. Not only can spironolactone lower blood pressure but can also help with the unwanted symptoms of hirsutism such as excessive hair growth and hair loss.

Beta Blockers

Beta blockers work by blocking the adrenaline hormone epinephrine to slow your heart rate.

ACE Inhibitors

ACE inhibitors relax your blood vessels so the heart doesn’t have to work so hard to pump blood through narrow vessels.

Calcium Channel Blockers

Calcium channel blockers lower blood pressure by preventing calcium from entering the heart and narrowing blood vessels, which decreases the amount of force the muscle can generate when contracting.

Because you don’t know if you have high blood pressure or not, it’s important that you follow up with your medical provider for checkups throughout the year. Applying the lifestyle tips above can help to prevent and treat high blood pressure.

Sources

Asemi Z, Esmaillzadeh A. DASH Diet, Insulin Resistance, and Serum hs-CRP in Polycystic Ovary Syndrome: A Randomized Controlled Clinical Trial. Horm Metab Res. 2014.

Center for Disease Control Measuring Blood Pressure. Accessed 2/22/17: https://www.cdc.gov/bloodpressure/measure.htm

Chang AY, Oshiro J, Ayers C, Auchus RJ.Influence of race/ethnicity on cardiovascular risk factors in polycystic ovary syndrome, the Dallas Heart Study. Clin Endocrinol (Oxf). 2016 Jul;85(1):92-9.

Moreno-Luna R, Muñoz-Hernandez R, Miranda ML. Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension. Am J Hypertens. 2012 Dec;25(12):1299-304.

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