Hypertension and Women

Hypertension Presents Special Challenges for Women.

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Hypertension is a significant health problem for many Americans. About 70 million adults in the United States, approximately one in three Americans, have hypertension. Only slightly more than half of Americans with high blood pressure have good control. Hypertension is a chronic disease that often results in damage to the heart, brain, blood vessels, and other organs, including the kidneys.

Why are there two numbers in your blood pressure measurement?

 The top number represents your systolic blood pressure, which is a measurement of the pressure in your blood vessels when your heart beats.

When your heart is resting between beats, your blood pressure is lower. This is represented by the bottom number, the diastolic blood pressure.

Are you at risk?

Many women consider themselves immune from hypertension. Although it's true that the risk of hypertension is lower in women compared to men, that advantage disappears when women reach  menopause. After menopause, women lose the protective effect of estrogen as levels decline.  In fact, women have a greater risk of hypertension than men beginning at the age of 65. Women can also develop hypertension before menopause, even though they are at reduced risk.

It's important to monitor blood pressure throughout adulthood since high blood pressure is usually unaccompanied by signs and symptoms until the damage to organs like the heart or kidneys has already occurred. Hypertension is a silent killer, so it's critical to remain alert.

Women have gender-specific risk factors

Oral contraceptives can increase blood pressure in some women.

You should be certain your doctor measures your blood pressure regularly and records it in your medical record. Smoking increases the risk even more. If you are considering taking an oral contraceptive pill and you smoke, be sure to discuss the increased risk with your doctor. The combination of smoking and oral contraceptives is dangerous in many women.

Women have a higher percentage of body fat compared to men.

Women have a higher percentage of body fat, which is a risk factor for hypertension. Fat that accumulates deep in the abdomen, known as visceral fat, is linked to hypertension, high cholesterol, heart disease, and insulin resistance. In fact, identification of metabolic syndrome, which is characterized by central obesity, elevated triglycerides, and high blood pressure, has led  researchers to explore this link carefully. Diets like the DASH diet have been demonstrated to decrease blood pressure. In addition to cutting calories, the DASH diet reduces salt consumption, another factor in blood pressure control.

What can you expect if you have hypertension and become pregnant?

If you have hypertension and you're taking medication, discuss your condition with your doctor before becoming pregnant. Your pregnancy can cause increased blood pressure and can be dangerous for both you and your baby. There are also certain medications that can be dangerous to mother and baby during pregnancy, including angiotensin receptor blockers (ARBs) and angiotensin converting enzyme inhibitors (ACEIs).

 It's important to stop these medications before you become pregnant, but don't stop any prescribed medication without consulting your physician.If you carefully follow the recommendations of your doctor to manage your blood pressure, you can remain healthy during your pregnancy and you can deliver a healthy infant.

Pregnancy Induced Hypertension (PIH) in women without a history of high blood pressure

It's not unusual for women without any history of high blood pressure to develop hypertension during pregnancy. This is one reason that prenatal care is so important for all expectant mothers. PIH, which is also known as gestational hypertension, usually resolves after delivery. It occurs in up to 8% of women who are pregnant, and most of the women who develop PIH are in their first pregnancy.  PIH can develop into preeclampsia, a condition that can result in harm to the placenta and fetus, in addition to potentially causing damage to the mother's organs,including the kidney, liver, and brain. Preeclampsia usually develops after the 20th gestational week. Some risk factors are high blood pressure before pregnancy; obesity; age under 20 years or over 40 years; multiple gestation (twins, etc.); and a history of preeclampsia in a prior pregnancy. Women with preeclampsia may develop symptoms like swelling and sudden weight gain, changes in vision, and headache. Their urine may contain protein. If eclampsia develops, the baby must delivered to prevent life-threatening complications.

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