Women on Red Alert for Hypertension

< Feb. 20, 2008 > -- According to the results of several studies published recently in the medical journal Hypertension, women with hypertension face unique challenges. For example, women struggle with controlling their blood pressure more than men.

Heart disease is the leading killer of women and men in the US, and high blood pressure is a major factor in such problems as heart attack and stroke.

Women Need to Know the Ideal Blood Pressure

"With only 60 percent of women with high blood pressure having their blood pressure controlled, we have a big problem that can lead to stroke and heart attack," says Dr. Nieca Goldberg, medical director of New York University Medical Center's Women's Heart Program, and a spokeswoman for the Go Red For Women campaign, sponsored by the American Heart Association (AHA).

There are several reasons for the problem, Dr. Goldberg says. "I think one is that women's needs aren't being met in the doctor's office," she says. "Doctors have to pay more attention to women's blood pressure."

Also, women need to be knowledgeable about what their blood pressure should be, Dr. Goldberg says. "Their optimal pressure should be less than 120/80 (mmHg) [millimeters of mercury]. By reducing blood pressure from 140/90 mmHg to 120/80 mmHg, you cut stroke risk in half and heart attack risk by 25 percent," she says.

Women also need to take steps to have their blood pressure diagnosed, Dr. Goldberg adds.

"Women shouldn't just let the doctor take their blood pressure, they should ask for their number. People are very goal oriented, and when a patient knows what the goal is, they can focus on achieving that goal," says Dr. Goldberg.

What is blood pressure? Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider, is the force of the blood pushing against the artery walls. Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts.

One cannot take his or her own blood pressure unless an electronic blood pressure monitoring device is used. Electronic blood pressure monitors may also measure the heart rate, or pulse.

Two numbers are recorded when measuring blood pressure. The top number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The bottom number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood.

Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of the blood.

High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) has determined two levels of high blood pressure for adults:

• Stage 1
  140 mm Hg to 159 mm Hg systolic pressure-higher number
  and 90 mm Hg to 99 mm Hg diastolic pressure-lower number

• Stage 2
  160 mm Hg or higher systolic pressure
  and 100 mm Hg or higher diastolic pressure

The NHLBI  defines prehypertension as:

• 120 mm Hg - 139 mm Hg systolic pressure and 80 mm Hg - 89 mm Hg diastolic pressure

The NHLBI guidelines define normal blood pressure as follows:

• Less than 120 mm Hg systolic pressure
  and less than 80 mm Hg diastolic pressure

These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem.

Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment. A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.

Women vs. Men

Another study found that US women were less inclined  to meet blood pressure target goals than men - 54 percent of women compared to 58.7 percent of men.

Women received fewer medications such as aspirin, blood pressure-lowering drugs or cholesterol-lowering drugs, compared to men, the study found.

Often women are confronted with high blood pressure during pregnancy, a finding validated in many studies. One in every 10 pregnancies is complicated by high blood pressure.

Women with high blood pressure are especially at risk for developing preeclampsia during pregnancy. Among women with preeclampsia, 48 percent deliver low birth-weight babies, and 51 percent have pre-term infants, researchers found.

Smoking can increase the risks that occur with preeclampsia, but stopping smoking can reduce those risks, British researchers found.

Dairy is a Must-Do

The studies also addressed things women can do to lower the risk of high blood pressure. One of them is eating low-fat dairy foods, Dr. Goldberg says.

One study looked at the benefit of low-fat dairy foods and found that women 45 years old and older who ate such foods were at lower risk of developing high blood pressure.

"In our study, we found that higher low-fat dairy intake, but not high-fat dairy intake, was associated with lower risk of hypertension," says lead researcher Dr. Lu Wang, of Brigham and Women's Hospital in Boston. "The association was partially attributed to calcium and vitamin D in dairy products."

Always consult your physician for more information.

Hypertension in Women: A Closer Look

Many people think that hypertension results from a lifestyle that is too stressful, including overwork, lack of exercise, too many business lunches, smoking, and eating an unhealthy diet. However, according to the American Heart Association (AHA), physicians do not really know the causes of hypertension.

What is clear is that about 73 million adults have it and almost half are women. And the AHA says that only a small number of people with the disease are adequately treated.

There are several other risk factors that women should be concerned about.

Researchers have found that birth control pills are linked to high blood pressure in some women. It is even more probable if you are overweight, have hypertension during pregnancy, or have a condition that makes you susceptible to hypertension, like mild kidney disease or a family history of the disease.

Smoking and taking birth control pills may be especially dangerous for certain women. Taking your blood pressure before starting on the pill is a good idea. It is also recommended that you have your blood pressure checked once you are on the pill every 6 months or so.

Another condition that increases your risk for hypertension is being overweight. Also, gaining a lot of weight may increase your blood pressure.

After menopause, a woman's rate of hypertension is greater than a man's.

The AHA also states that for some unknown reason, high blood pressure is more common in black women, even in very young black women. African American women have the disease more often than Caucasians and when they have high blood pressure, it tends to be more serious.

If your family, including your parents and close blood relatives, have high blood pressure, there is an increased chance that you will be affected also.

While there is no cure for high blood pressure, it can be controlled. If you have high blood pressure, you should work with your health care team to control it.

You may be asked to lose weight, use less salt, be physically active, and limit your alcohol intake. Your physician may also prescribe medication, which you may need to take daily. You may need to prepare yourself for the reality that you may need to take medication for the rest of your life.

With these tools at your disposal, it is short-sighted not to use them to control your hypertension and your health.

Always consult your physician for more information.