Women and Hypertension: Common Myths About High Blood Pressure in Women

One in three Americans have high blood pressure but only about half have blood pressures that are well-controlled. It’s easy to get lulled into complacency with hypertension. Most people are blissfully unaware that they have it, but despite their lack of awareness, high blood pressure silently damages blood vessels throughout your body and vital organs like your kidneys, heart and brain. It truly is a silent killer.

Hypertension is a concern for both men and women because it’s a leading contributor to heart disease, a condition that’s often underdiagnosed in women. Here are some common myths about hypertension in women you should be aware of to keep your own heart and blood vessels healthy.

Hypertension Myth: Hypertension is More Common in Males

It’s true that men have a higher average blood pressure and a greater incidence of hypertension during early adulthood and middle age, but women rapidly “catch up” after menopause. By age 65, more women than men have high blood pressure.

Why does the incidence of high blood pressure rise after menopause? The natural decline in estrogen levels after menopause is a factor. That’s because estrogen improves “endothelial function,” the ability of blood vessels to dilate. After menopause as estrogen levels decline, blood vessels become more “rigid,” leading to an increase in blood pressure. Plus, many women gain weight after menopause. This puts them at greater risk for high blood pressure as well. That’s why it’s important to monitor your blood pressure closely after menopause.

 High Blood Pressure Myth: Hormone Replacement Therapy Reduces the Risk for Hypertension

Despite the fact that estrogen improves endothelial function, and declining estrogen levels are linked with a greater risk for hypertension, a large study involving over 40,000 women showed using hormone replacement therapy long-term actually increases the risk for high blood pressure. In this study, more women who used hormone replacement therapy had hypertension than those that didn’t. Plus, there are the other negative effects of hormone replacement including an increased risk for breast cancer.

On the plus side, hormone replacement therapy has favorable effects on cholesterol and blood lipids. Plus, studies suggest it lowers the risk of heart disease in women under the age of 60, although it does slightly increase the risk for strokes and blood clots. Discuss the pros and cons of taking hormone replacement therapy with your doctor.

Hypertension Myth: Women Are More Likely to Have Well-Controlled Blood Pressure than Men

A National Health and Nutrition Examination study showed that women are more likely to be treated for high blood pressure than men but they’re also more likely to have inadequate blood pressure control. In fact, two-thirds of women receiving treatment for hypertension have blood pressures that are poorly controlled. This becomes more of a problem as women age.

With age comes other medical problems like diabetes. It’s especially important for women with diabetes to adequately control their blood pressure since diabetes is another risk factor for heart disease. Women with uncontrolled blood pressure and diabetes have a greatly increased risk for heart disease.

High Blood Pressure Myth: Women Who Have High Blood Pressure Don’t Need to Watch Their Salt Intake

It may be more important for women to reduce their sodium intake than men. A large study called the dietary Approaches to Stop Hypertension Trial (DASH) showed that women who reduced the amount of sodium in their diet experienced significant improvements in blood pressure. One study even showed that sodium reduction improved blood pressure control better than aerobic exercise.

Keep in mind that the biggest source of sodium in your diet is processed and packaged foods. Eat more whole foods and you’ll naturally reduce the amount of sodium in your diet. Ideally, try to keep the sodium content of your diet to no more than 1,500 milligrams a day if you’re at high risk for high blood pressure.

Hypertension Myth: If You’re Genetically Programmed to Get Hypertension, You’re Going to Get It

You may have genes that predispose you to hypertension but that doesn’t mean they’ll be expressed. Lifestyle changes including regular exercise (both aerobic and resistance training), weight loss if you’re overweight, sodium reduction and taking measures to reduce stress all help to delay or even prevent hypertension.

It’s also important to eat a potassium and magnesium-rich diet and fatty fish since there’s evidence that omega-3s help to lower blood pressure. Doing these things can help delay the onset of hypertension, control high blood pressure and even prevent it in some cases. Plus, these are all heart-healthy habits you should be doing anyway.

 

The Bottom Line?

Whether you’re male or female, it’s important to monitor your blood pressure regularly. Women are at lower risk for high blood pressure prior to menopause but then their risk rises significantly. Why is blood pressure control so important? Heart disease kills more women than cancer, lung disease, accidents and Alzheimer’s disease combined and one way to reduce your risk for heart disease is to keep your blood pressure under good control. Know what your numbers are and make sure they still within normal range.

 

References:

Medscape.com. “Hypertension in Women”

TheHeart.org. “HRT ups BP; risk of hypertension higher with longer duration of use”

J Hum Hypertens. 2002 Jul;16(7):509-16.

J Am Coll Cardiol. 2001 Aug;38(2):506-13.

 

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