With data suggesting that one in three women worldwide suffers from high blood pressure (hypertension), and with cardiovascular disease being the leading cause of death in women, specialists have said all women should know their blood pressure, to help prevent heart disease and stroke in later life.
Issuing the advice on World Hypertension Day (17 May), doctors from the European Society of Cardiology (ESC) said women should start treating hypertension in middle age to prevent symptoms like shortness of breath and fatigue as they grow older.
Globally, reports The Independent, the condition has been named the most important risk factor for death in women
Professor Angela Maas, emeritus director of the Women’s Cardiac Health Programme, Radboud University Medical Centre, The Netherlands, said: “The risk for cardiovascular disease increases at a lower blood pressure (BP) level in women than with men.
“Women should take their BP seriously, know their values, and convince their doctor they need treatment if it is too high. The long-effects of high BP should never be under-estimated.”
One of the most important consequences of hypertension in women is a type of heart failure in which the heart muscle is stiff, she added.
“There are few treatments for that condition, so to avoid symptoms like shortness of breath, fatigue and fluid retention when they are over 70, they must start treating high blood pressure in middle age. If they wait 20 years, it is too late.”
Despite its importance, hypertension is more often underestimated and not, or insufficiently, treated in women compared with men, said Maas.
“One of the reasons may be that below the age of 50, hypertension is more prevalent in men. But this reverses in the years after menopause so that after 65, hypertension is more common in women.”
It was a misconception, said the experts, that high BP does not cause symptoms. In fact, symptoms are more pronounced in women but may be mistaken for menopause, anxiety or stress.
Young and middle-aged women with high BP often report palpitations, chest pain, pain between the shoulder blades, headaches, difficulty concentrating, shortness of breath, tiredness, fluid retention, poor sleep, hot flushes and a feeling their bra is too tight.
They said hypertension in midlife is more harmful in women than in similarly aged men, and is a stronger risk factor for heart attack, cognitive decline and dementia.
The probability of stroke increases at a lower BP level in women than in men, while high BP raises the risk for heart failure in women by three-fold, compared with two-fold in men.
Maas said: “Hypertension is currently defined as a systolic blood pressure of at least 140 mmHg and/or diastolic blood pressure of 90 mmHg or higher.
“But discussions are under way about whether normal BP values should be lower in women than in men.
“More research is needed before there is any change in treatment guidelines but I expect that within five years the threshold for normal blood pressure will be lower in women than men.”
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New NICE hypertension guidelines a ‘pragmatic compromise’ — The Lancet
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