High Blood Pressure: What Women Need to Know
May 29, 2020 Cedars-Sinai Staff
About 11 million Americans with high blood pressure don't know they have the condition, according to the Centers for Disease Control and Prevention (CDC). The "silent killer" raises the likelihood of a heart attack, heart failure and stroke when it's not caught early enough or adequately treated. The stakes might be even higher for women, who often don't realize they're at risk.
It's not well understood how high blood pressure, or hypertension, progresses in women versus men, but new research from the Smidt Heart Institute at Cedars-Sinai suggests there might be key differences.
"Hypertension is underrecognized, it's undertreated and likely it's because of some implicit bias that makes most providers assume all young women are healthy."
The study found that blood pressure starts rising earlier and advances faster in women. That's why it's critical women pay closer attention to their blood pressure, says Dr. Noel Bairey Merz, director of the Cedars-Sinai Barbra Streisand Women's Heart Center and a leading expert on gender differences in heart disease.
"We need to do a much better job of early detection and treatment of hypertension in young women," she says.
Here are some things women need to know about blood pressure to stay safe:
Women are at risk for health complications related to blood pressure
High blood pressure could be even more serious for young women than young men, according to the study findings.
The study found women's blood vessels age faster than men's, meaning a 30-year-old woman with hypertension is probably more likely to develop cardiovascular problems than her male counterpart.
"Our research not only confirms that women have different biology and physiology than their male counterparts," says Dr. Susan Cheng, the study's senior author and director of public health research at the Smidt Heart Institute. "But also illustrates why women may be more susceptible to developing certain types of blood pressure-related cardiovascular disease—and at different points in life."
Regular blood pressure checks are key
Blood pressure should be checked annually, the American Heart Association (AHA) recommends. Many young women don't get their blood pressure read as often as they should, usually because they see an OB-GYN for primary care, Dr. Bairey Merz notes.
But you don't have to wait to see a doctor to keep tabs on your blood pressure. Dr. Bairey Merz encourages women to buy their own blood pressure machines and self-monitor. The home devices are effective and can range in price. There are many affordable options available.
Be your own advocate
While one high reading might not necessarily mean a problem, when women have their blood pressure read, elevated results can be dismissed.
Arm yourself with facts, including about your own medical history, and be ready to ask questions or get a second medical opinion if needed
"Hypertension is underrecognized, it's undertreated and likely it's because of some implicit bias that makes most providers assume all young women are healthy," Dr. Bairey Merz says.
"There's a common misunderstanding that women are immune to high blood pressure."
Protecting yourself also extends to prevention
Interventions and lifestyle changes can make a big difference in keeping your blood pressure within the healthy range. Obesity increases hypertension risk, and women are more likely to be obese than men.
Dr. Bairey Merz recommends regular exercise and reducing salt intake. She points to a Mediterranean-style diet that includes eating more fruits and vegetables, less red meat, daily servings of nuts and legumes, and avoiding processed foods.
She also suggests limiting alcohol, which can cause more problems for women than men because of liver size. High stress can also make blood pressure worse.
Guidelines could change as more research emerges
The latest research that found gender differences in high blood pressure is observational and isn't enough to warrant new recommendations—at least not yet, Dr. Bairey Merz says. But more research is urgently needed, she adds.
Better understanding health differences between the genders is the easiest way to deliver personalized medicine that works better for both women and men according to, Dr. Bairey Merz.
"We've studied men for 80 years," she says. "Don't you think it's time we study women?"