Gender matters: Understanding the unique differences of high blood pressure in women 

Heart Health
Women's Health
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High blood pressure, also known as hypertension, is when your blood pressure — or the pressure that comes from blood pushing on your artery walls — is higher than it should be (at or above 130/80 mmHg). High blood pressure is one of the most common health conditions in the U.S., and nearly half of all adults have it.

Despite its prevalence, there’s a misconception that high blood pressure doesn’t impact women as often as men. This is not the case. In fact, women are just as likely to have high blood pressure, and there are specific aspects of being a woman that can influence when and how high blood pressure develops.

"It’s crucial to understand the risks associated with high blood pressure and its potential impact on your overall well-being," says Katie Hawthorne, MD, a cardiologist at Lankenau Heart Group, part of Main Line Health.

Be sure to empower yourself with knowledge and discover proactive measures for what you can do to stay healthy.

Effects of high blood pressure on your health

High blood pressure may be common, but about 1 in 5 people with high blood pressure don’t know they have it, meaning they aren’t able to take steps to keep it under control.

Uncontrolled high blood pressure poses a dual threat to your cardiovascular system. The potential damage and blockage of arteries supplying blood to the heart increase the risk of heart disease and heart attack. This condition also jeopardizes blood flow to the brain, elevating the risk of stroke.

High blood pressure also increases your risk of:

  • Heart failure, which occurs when the heart becomes too large and can’t supply blood to the body.
  • Peripheral artery disease (PAD), which occurs when the arteries in the legs, arms, stomach and head become narrowed, leading to fatigue or pain.
  • Kidney disease, which occurs when the kidneys can’t filter blood effectively.
  • Sexual dysfunction, including lowered sex drive.
  • Vision loss, due to the blood vessels in the eyes becoming strained or damaged.

Unique impact of high blood pressure on women's health

Women have different anatomies than men, which can lead to differences in the way health conditions develop. When it comes to high blood pressure, certain circumstances can impact your risk of high blood pressure and related complications.

Balancing risks of birth control and high blood pressure

Three of the most common kinds of birth control — combined hormonal birth control pills, the birth control patch and the vaginal ring — contain a hormone called estrogen. Estrogen plays a role in your reproductive health, including menstruation and pregnancy.

"Birth control that contains estrogen can increase your blood pressure. As a result, some women who currently have high blood pressure are recommended not to take these types of birth control, as it can put them at an increased risk of heart attack and stroke," says Dr. Hawthorne.

If you have high blood pressure and are considering birth control, talk to your health care provider about the best option for you, such as an intrauterine device (IUD), condoms or progestin-only birth control, like the minipill.

Safe-guarding against pregnancy-related high blood pressure

When you’re pregnant, your body produces more blood to support the growth of your baby. If your blood pressure is high during pregnancy, this can cause problems for both you and your baby.

High blood pressure during pregnancy can put extra stress on your heart and kidneys, which can lead to heart disease, stroke and kidney disease. It can also put your baby at risk by reducing blood flow to the placenta (the organ that delivers nutrients to and removes waste away from your baby). This can disrupt the flow of nutrients and oxygen to your baby.

High blood pressure can also lead to pregnancy complications, like preterm birth delivery before 37 weeks), placental abruption (when the placenta separates either partially or entirely from the uterine wall prior to delivery) and unplanned cesarean birth.

Finally, high blood pressure during pregnancy can also lead to a serious condition called preeclampsia, which is when you have high blood pressure and other signs of organ issues. Although blood pressure generally improves after delivery, experts do not know exactly what causes preeclampsia.

"In fact, preeclampsia can make you twice as likely to have a future heart attack or stroke and four times as likely to develop high blood pressure," says Dr. Hawthorne.

If you’ve had preeclampsia, be sure you have regular follow-ups to monitor your heart health.

Navigating the change: understanding the link between menopause and high blood pressure

After menopause (12 months after your last period), your blood pressure is likely to increase. This can be because of changing hormones, an increase in body mass index (BMI), a new sensitivity to sodium in your diet, certain types of hormone therapy for menopause or a combination of multiple factors.

This risk makes it extra important to control your blood pressure leading up to, during and after menopause. This can be done through healthy lifestyle choices, like maintaining a healthy weight, eating nutritious foods (including limiting salt and processed foods), getting regular exercise, managing stress and not smoking.

Managing blood pressure throughout all stages of life

Monitoring your blood pressure and managing high blood pressure is always important, no matter what stage of life you’re in. By keeping up with regular health care appointments, your provider can check your blood pressure. Depending on your individual situation, you may also be recommended to monitor your blood pressure at home.

Maintaining a healthy blood pressure is one of the most effective ways to avoid health complications, some of which can be life-threatening. To ensure a healthy future, stay informed about your blood pressure and take steps to keep it in a healthy range.

Next steps:

Make an appointment with Katie Hawthorne, MD
Treating heart health before and after pregnancy
Should you get an at-home blood pressure monitor?

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