High Blood Pressure a Special Concern for Women Written by Stephen T. Sinatra, MD, FACC Like heart disease, high blood pressure (also known as hypertension) has always been thought of as a man’s problem—but it just isn’t so. As it turns out: • Women are more likely to have high blood pressure because they have smaller arteries than men. • After age 55, more women develop high blood pressure than men. • Even a mild elevation in blood pressure (around 130–139 mmHg systolic, or 85–89 mmHg diastolic) has been found to actually double a middle-aged woman’s cardiac risk. • High blood pressure affects one out of every four women and kills significantly more women than men. Considering these statistics, women need to be aware of a number of life circumstances and lifestyle choices that can make maintaining optimal blood pressure a unique challenge:
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• Birth control • Pregnancy • Menopause • Metabolic syndrome • Diastolic dysfunction • Painkillers • Emotions • Birth Control
Oral contraceptives may elevate blood pressure slightly. Usually a woman’s numbers will stay in the normal range, but they should be checked regularly because high blood pressure is a potential side effect—particularly for women with a family history of hypertension or a personal history of kidney disease, obesity, or hypertension during pregnancy. Pregnancy Many women with high blood pressure deliver healthy babies (high blood pressure during pregnancy is called eclampsia). But pregnancy—and the increased blood volume required to nurture a growing fetus—can potentially raise blood pressure to extremely high levels. For this reason, expectant mothers also should have blood pressure readings taken routinely. Hypertension can develop rapidly in the last three months of pregnancy. When this happens, a woman may need treatment—even after delivery. Menopause Normal age-related hormonal declines often cause a woman’s arteries to become less elastic and more constrictive, thus contributing to high blood pressure. On their own, these changes are reason enough to pay extra attention to your lifestyle choices that affect cardiovascular health. But the situation is further complicated by the use of hormone replacement therapy (HRT) to minimize or eliminate other symptoms of menopause, like hot flashes and night sweats. Conventional HRT involves the use of manmade pharmaceutical substitutes for the hormones the body is no longer producing enough of. These synthetic hormones may be problematic, however. In 2004, results from the large Women’s Health Initiative (WHI) study showed that synthetic hormones like Premarin and Provera could push blood pressure up steeply. An alternative to HRT is individually tailored bioidentical hormones derived from natural plant sources. I believe these are a much better option for women who want to use some type of HRT. Metabolic Syndrome Data from a five-year National Health and Nutrition Examination study of adults with hypertension revealed three risk factors for high blood pressure that are more significant for women than
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