Hypertension is often considered a men’s health problem, but that’s a myth. Men and women in their 40s, 50s, and 60s have a similar level of risk for developing high blood pressure.
But after the onset of menopause, women actually face higher risks than men of developing high blood pressure. Prior to age 45, men are slightly more likely to develop high blood pressure, but certain female health issues can change these odds.
High blood pressure in women often written off as menopausal symptoms
According to a new consensus document from European cardiologists, gynaecologists, and endocrinologists, research suggests that high blood pressure in women is often written off as either stress or menopausal symptoms.
The document suggests that doctors should take stronger steps to identify high blood pressure in middle-aged women as early detection and treatment are important in preventing serious outcomes like heart failure and stroke.
When the diagnosis is overlooked, however, it can cause women to delay treatment, putting them at greater risk for such conditions and better recognition of high blood pressure is an important step to reducing women’s cardiovascular risk.
Why does it get given low priority in middle-aged women?
Dr. Angela H.E.M. Maas, who was the lead author of the document, said that high blood pressure is taken more seriously in men and less well treated in women.
She said this is because we consider elevated blood pressure in women often as “stress,” and in men as “hypertension.”
“This is partly because of bias by doctors, but also by women themselves,” Maas said. “Women often explain an elevated blood pressure as stress-related and are not always open to the hypertension diagnosis and treatment.”
Maas said it can often take more time to convince women and to start and continue medical treatment.
“The timing of onset of hypertension is often at the start of menopause and this leads to overlapping symptoms that are not always properly adjudicated,” she said.
In the past, women were considered less likely than men to have heart disease, according to Dr. Maan Malahfji, a cardiologist with Houston Methodist DeBakey Cardiology Associates, who was not associated with the consensus report.
This may have resulted in doctors being less aggressive in investigating its symptoms and controlling them.
What types of hypertension symptoms can be mistaken for menopause?
Maas said one thing that leads to confusion in diagnosing high blood pressure in middle-aged women is the fact that its onset often coincides with menopause.
When symptoms occur that overlap with menopausal symptoms, people may simply dismiss them as being menopause.
“Think of hot flushes, sleeping disorders, chest pain, pain between the shoulder blades, irregular heartbeats, headaches, symptoms of fluid retention, dyspnea (shortness of breath), etc.,” she said.
These are all symptoms that overlap with hypertension symptoms.
In addition, Malahfji pointed to symptoms like headaches, ringing in the ears, and changes in concentration as potential high blood pressure symptoms that might be attributed to menopause.
Why are women at greater risk after menopause?
“Estrogens are the most perfect vasodilators in young women,” Maas said, “but this reverses after menopause and estrogens cannot prohibit vascular aging.”
Under the age of 50, the absolute risk for a cardiovascular event is lower in women than in men, but this changes between 50 and 70. This means that the time frame 50-70 or, even better, between 40 and 70 years, is crucial to start early prevention,” Maas said.
At menopause unfortunately is when many women do start to put on weight, particularly on the belly, and this is where oestrogen is being deposited. However if you are low in oestrogen you do need to look at your hormone balance to ensure you have oestrogen balanced by progesterone.
Why is it so important to detect and treat high blood pressure?
According to the most recent Global Burden of Disease report, high blood pressure is the number one mortal risk factor for women globally.
“It often starts around menopause, is less well treated because it is too often attributed to menopause, and then after 70 years it leads to heart failure, with a stiffened heart, atrial fibrillation, valvular heart disease, and strokes,” Maas said.
In addition, renal failure and heart attacks may occur.
“If we compare cardiovascular disease risk factors in men and women greater than 70 years, hypertension occurs much more often in women,” she added.
Malahfji agreed that the risks associated with long-term high blood pressure are tremendous and include heart attack, stroke, and, particularly for women, heart failure, he said.
“Early treatment is key,” Malahfji said and the all of these risks can be modified by treating high blood pressure and treatment is associated with better quality of life and a longer life.
What are the symptoms of high blood pressure in women?
Blood pressure is the force of blood pushing against the inside lining of the arteries. High blood pressure, or hypertension, occurs when that force increases and stays higher than normal for a period.
This condition can damage the blood vessels, heart, brain, and other organs. About 1 in 5 people in the UK have high blood pressure, that’s over 11 million.
Blood pressure can increase without any noticeable symptoms. You can have high blood pressure and experience no obvious symptoms until you experience a stroke or heart attack.
In some people, severe high blood pressure can result in nosebleeds, headaches, or dizziness. Because hypertension can sneak up on you, it’s especially important to monitor your blood pressure regularly.
As hypertension is so common at menopause it is helpful to take positive steps to reduce its impact. Hormone balance is a key factor, and things to avoid include excessive consumption of alcohol, excessive use of pain medications such as NSAIDs.
Watching your weight will make a difference too so pick a healthy regime and try to maintain a regular exercise routine as that will all help you in maintaining a healthy blood pressure.
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