How Hypertension Affects Women
According to indicators from the World Health Organization (WHO), 1 in 5 women suffers from hypertension. Although it’s known to be more common in men, hypertension in women is conditioned by a number of factors. As the American College of Cardiology notes, these include your oral contraceptive intake, your body fat percentage, and pregnancy.
The WHO reminds us that cardiovascular diseases are the main cause of death in the female population. These can be caused by high blood pressure, or generate it as a side effect. In any case, levels should be monitored during adulthood, especially if there’s a family history or if you’re part of risk groups.
Hypertension in women
Hypertension in women has been thoroughly studied. For example, it is known that, although blood pressure is usually higher in men, the prevalence of the disease is more common in women after 65 years.
Importantly, despite advances in the field, the pathophysiological mechanisms of sex difference are still not fully understood. Among the risk factors exclusive to women we highlight:
Oral contraceptive intake
Although more studies are needed in this regard, the evidence suggests an increase in blood pressure in women who take a permanent intake of oral contraceptives.
Some research highlights that hypertension in these groups can be up to 5%. The percentage increases if the drug is combined with tobacco and there’s obesity.
This is why women taking the contraceptive pill are advised to regularly monitor their blood pressure levels. If they notice any changes, it should be reported to the specialist doctor. It’s possible that changes in estrogen and progestin levels are to blame for these imbalances.
Body fat percentage
The distribution and composition of body fat is known to vary according to gender. In women, the percentage of fat is slightly higher. Early diagnosis of the disease has been associated with elevated levels of epicardial and visceral fat.
Specifically, the evidence indicates that there’s a relationship between a higher percentage of body fat and increased blood pressure in women. On the contrary, studies suggest that a reduction in this is beneficial for the control of blood pressure levels in diagnosed women.
It’s important to note that increased fat percentages due to a hormonal or dietary imbalance can lead to the development of other conditions. These include high cholesterol, insulin resistance, heart disease, and metabolic syndrome.
Pregnancy and hypertension in women
Special mention should be made of pregnancy and hypertension in women. It isn’t considered uncommon for the gestation process to raise blood pressure, it has even been suggested that it occurs in between 6% and 10% of cases.
This is known as pregnancy-induced hypertension. Evidence indicates that it’s the leading cause of maternal and perinatal morbidity.
It’s more common in the first pregnancy and most of the time disappears after birth. If not controlled, it can lead to pre-eclampsia, on average during, or after, the twentieth week of gestation. These episodes are more common in multiple pregnancies, in women younger than 20 years or older than 40 years, and with obesity as a comorbidity.
This is why it’s important to monitor blood pressure levels during pregnancy. It’s a dangerous condition, as it doesn’t produce symptoms detectable by the mother.
Some studies have linked the presence of hypertension during pregnancy with low baby weight, a factor that can condition its development in the later stages.
Menopause and hypertension
The hormonal changes that occur during and after menopause can be catalysts for the development of hypertension in women.
It’s estimated that the presence of this condition in women over 65 years of age is up to 60%, with implications that are still completely misunderstood. According to some studies, the symptoms of high blood pressure are often confused with the aftermath of menopause.
There is a consensus demonstrated by this evidence that estrogen represents a protector or regulator of high blood pressure levels.
Its presence activates a series of vasodilator mechanisms and inhibits vasoconstrictor episodes when it’s at optimal levels. When these decrease, women are exposed to alterations that can put their health at risk.
Because of this, women over 50 should monitor their blood pressure levels. This should be done at least once a year, with shorter intervals if you’re part of one of the risk groups or according to the specialist’s recommendations.
Finally, it’s important to note that, in general terms, there’s no difference in the treatment of hypertension for men or women. In some contexts, this may differ, as in pregnancy, but the percentage is the same.
- Ashraf, M. S., & Vongpatanasin, W. Estrogen and hypertension. Current hypertension reports. 2006; 8(5): 368-376.
- Faria, A. N., Filho, F. F. R., Ferreira, S. R. G., & Zanella, M. T. Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women. Obesity research. 2002; 10(12): 1203-1206.
- Gudmundsdottir, H., Høieggen, A., Stenehjem, A., Waldum, B., & Os, I. Hypertension in women: latest findings and clinical implications. Therapeutic advances in chronic disease. 2012; 3(3): 137-146.
- Granger, J. P., Alexander, B. T., Bennett, W. A., & Khalil, R. A. Pathophysiology of pregnancy-induced hypertension. American journal of hypertension. 2001; 14(S3): 178S-185S.
- Lubianca, J. N., & Faccin, C. S. Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women. Contraception. 2003; 67(1): 19-24.
- Kanai, H., Tokunaga, K., Fujioka, S., Yamashita, S., Kameda-Takemura, K., & Matsuzawa, Y. Decrease in intra-abdominal visceral fat may reduce blood pressure in obese hypertensive women. Hypertension. 1996; 27(1): 125-129.
- Kintiraki, E., Papakatsika, S., Kotronis, G., Goulis, D. G., & Kotsis, V. Pregnancy-induced hypertension. Hormones. 2015; 14(2): 211-223.
- Maas, A. H. E. M., & Franke, H. R. Women’s health in menopause with a focus on hypertension. Netherlands Heart Journal. 2009; 17(2): 68-72.
- Neves, E. B., Salamunes, A. C. C., de Oliveira, R. M., & Stadnik, A. M. W. Effect of body fat and gender on body temperature distribution. Journal of thermal biology. 2017; 70: 1-8.
- Pimenta, E. Hypertension in women. Hypertension Research. 2012; 35(2): 148-152.
- Sironi, A. M., Pingitore, A., Ghione, S., De Marchi, D., Scattini, B., Positano, V., … & Gastaldelli, A. Early hypertension is associated with reduced regional cardiac function, insulin resistance, epicardial, and visceral fat. Hypertension. 2008; 51(2): 282-288.
- Taddei, S. (2009). Blood pressure through aging and menopause. Climacteric, 12(sup1), 36-40.
- Urrea, J. Hipertensión arterial en la mujer. Revista Colombiana de Cardiología. 2018; 25: 13-20.
- Xiong, X., Mayes, D., Demianczuk, N., Olson, D. M., Davidge, S. T., Newburn-Cook, C., & Saunders, L. D. Impact of pregnancy-induced hypertension on fetal growth. American journal of obstetrics and gynecology. 1999; 180(1): 207-213.
- Woods, J. W. Oral contraceptives and hypertension. Hypertension. 1988; 11(3_pt_2); II11.
