Overview of Women and High Blood Pressure

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Nurse putting blood pressure cuff on patient

One in 4 adult Americans has high blood pressure (hypertension), although about a third of them don’t know why. These statistics are concerning when you consider that high blood pressure is easy to diagnose and treat, and particularly alarming because hypertension is one of the most preventable causes of death in the United States.

Many people falsely assume that men are the most at risk for cardiovascular diseases, but at publication time, more women than men had died of cardiovascular diseases every year since 1984. Untreated high blood pressure can cause kidney damage and raises the risk of heart attack, stroke, and other cardiovascular diseases. The cause of 3 out of 5 cases of heart failure in women is high blood pressure.

Coronary heart disease is the number one killer of American women, claiming more than 500,000 women’s lives each year. Early detection and treatment of high blood pressure could prevent many of these deaths.

Who’s at Risk

High blood pressure can happen to anyone at any age. It is often difficult to pinpoint a cause for high blood pressure since several factors and conditions often play a role in its development.

Race and even geographic location appear statistically significant in some cases. African-American women who live in the Southeast United States are more likely to have high blood pressure than those who live elsewhere. Overall, African-Americans are more likely to develop high blood pressure at an earlier age and more severely than whites.

However, this certainly does not mean that the white population should consider high blood pressure an African-American disease. In fact, 11 states (Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia) in the Southeast are known as the “Stroke Belt States” because of the high rate of strokes experienced by males and females of all races.

Other factors that contribute to high blood pressure include smoking, lack of physical activity, overweight, high sodium intake, high cholesterol, excessive intake of alcoholic beverages, and heredity. Diabetes patients also are at greater risk for high blood pressure and other cardiovascular diseases.

Women who use oral contraceptives should have their blood pressure closely monitored, although the risk from oral contraceptives is much lower than it was previously because the amount of estrogen and progestin in today’s pills is significantly less. Women with high blood pressure who smoke and use oral contraceptives face a 10 to 15 times greater risk of stroke.

After menopause, a woman’s risk of high blood pressure and other cardiovascular diseases increases greatly; the risk increases significantly faster for women after hysterectomy, perhaps because the uterus produces chemicals that help regulate blood pressure.

The increase in the risk of heart disease for women after menopause is thought to occur because of declining estrogen levels. For years it was believed that estrogen replacement therapy (hormone replacement therapy, or HRT) offered a protective effect against heart disease for women when taken regularly. However, information obtained from the Women’s Health Initiative in April 2000 found that estrogen increases the risk of heart disease.

According to a Women’ s Health Initiative fact sheet:

“No study has ever proven that HRT will reduce heart attacks. Several studies have been conducted on the effect of HRT and heart disease which have suggested that HRT decreases heart disease risk of heart disease risk factors such as LDL levels. However, these studies were mostly observational studies where women themselves, or their physicians, chose HRT and were followed over time. Such studies are not reliable. They were not controlled enough to offer definitive answers.”

Like oral contraceptive users, women who smoke and use estrogen may additionally increase their risk of cardiovascular disease.


Although some patients may experience headaches, dizziness, or blurred vision, most times no symptoms are present. You may be completely unaware that you have high blood pressure until something happens that requires medical attention. Women who experience a lack of sexual desire should have a blood pressure check since some believe that high blood pressure can cause low libido in some women.

Regular blood pressure checks should be a part of everyone’s routine health screening. Self-serve blood pressure monitoring equipment is available at many pharmacies, and most hospitals and clinics will perform blood pressure screening free upon request.

Blood pressure measures two numbers. The top number is the systolic pressure—the pressure of blood in the vessels as the heart beats. The lower number is the diastolic pressure—the pressure of the blood between heartbeats. Blood pressure is considered high when the systolic pressure is 140 or above and/or when diastolic pressure is 90 or above.


The good news about high blood pressure is that it is easily controllable. If your blood pressure is high, your physician will determine whether medication to lower your blood pressure is required. He may choose for you to make changes to your lifestyle before or during treatment with medication.

Lifestyle changes alone often effectively reduce blood pressure and may include:

  • Losing weight, if necessary
  • Following a heart-healthy diet
  • Engaging in regular physical activity—30 minutes of walking or other aerobic activity a day
  • Restricting the amount of sodium in your diet
  • Limiting alcoholic beverages
  • Quitting smoking

Several types of medications are available to treat high blood pressure. Medical treatment is often used in conjunction with lifestyle therapies. Some of the most commonly used medications to treat high blood pressure include:

  • Diuretics
  • Beta-blockers
  • ACE (angiotensin-converting enzyme) inhibitors
  • Calcium channel blockers
  • Alpha-beta blockers

These drugs may be used alone or in combination, depending on what your physician determines is best for your situation. If your physician orders medication, it is important that you take the medication exactly as prescribed and don’t stop without his order. Suddenly stopping blood pressure medication can cause your blood pressure to rise rapidly.

If you have been diagnosed with high blood pressure, it is vital that you follow your physician’s recommendations to the letter. Following your doctor’s orders will help lower your blood pressure and your risk of cardiovascular disease. Discuss any questions you have with your physician—it’s imperative that you understand your treatment plan and its potential benefit to your life and health.

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