High Blood Pressure and Women

Discover why high blood pressure is a special concern for women

Like heart disease, high blood pressure (also known as hypertension) has always been thought of as a man’s problem—but it just isn’t so. As it turns out:

• Women are more likely to have high blood pressure because they have smaller arteries than men.
• After age 55, more women develop high blood pressure than men.
• Even a high-normal blood pressure (around 130–139 mmHg systolic, or 85–89 mmHg diastolic) has been found to actually double a middle-aged woman’s cardiac risk.
• High blood pressure affects one out of every four women and kills significantly more women than men.

Considering these statistics, women need to be aware of a number of life circumstances and lifestyle choices that can make maintaining optimal blood pressure a unique challenge:

• Birth Control
• Pregnancy
• Menopause
• Metabolic Syndrome
• Diastolic Dysfunction
• Painkillers
• Emotions

Birth Control

Oral contraceptives may elevate blood pressure slightly. Usually a woman’s numbers will stay in the normal range, but they should be checked regularly because high blood pressure is a potential side effect—particularly for women with a family history of hypertension or a personal history of kidney disease, obesity, or hypertension during pregnancy.

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Pregnancy

Many women with high blood pressure deliver healthy babies (high blood pressure during pregnancy is called eclampsia). But pregnancy—and the increased blood volume required to nurture a growing fetus—can potentially raise blood pressure to extremely high levels. For this reason, expectant mothers also should have blood pressure readings taken routinely. Hypertension can develop rapidly in the last three months of pregnancy. When this happens, a woman may need treatment—even after delivery.

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Menopause

Normal age-related hormonal declines often cause a woman’s arteries to become less elastic and more constrictive, thus contributing to high blood pressure. On their own, these changes are reason enough to pay extra attention to your lifestyle choices that affect cardiovascular health. But the situation is further complicated by the use of hormone replacement therapy (HRT) to minimize or eliminate other symptoms of menopause, like hot flashes and night sweats.

Conventional HRT involves the use of man-made pharmaceutical substitutes for the hormones the body is no longer producing enough of. These synthetic hormones may be problematic, however. In 2004, results from the large Women’s Health Initiative (WHI) study showed that synthetic hormones like Premarin and Provera could push blood pressure up steeply.

An alternative to HRT is individually tailored bioidentical hormones derived from natural plant sources. I believe these are a much better option for women who want to use some type of HRT.

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Metabolic Syndrome

Data from a five-year National Health and Nutrition Examination study of adults with hypertension revealed three risk factors for high blood pressure that are more significant for women than men: low HDL cholesterol levels, elevated total cholesterol levels, and excess abdominal fat (waist girth of more than 35 inches). This profile is largely consistent with metabolic syndrome, a widespread asymptomatic condition that often leads to diabetes and heart disease.

I’ve found that women with these characteristics typically don’t respond well to medications for high blood pressure. They do better with lifestyle changes that include exercise and weight loss, stress reduction, diet modifications, and targeted nutritional supplements to support normal blood pressure levels.

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Diastolic Dysfunction

Another reason that women have a tougher time with high blood pressure is their tendency to have more diastolic dysfunction (DD) than men. DD is a condition in which the left ventricle of the heart—the chamber that generates your systolic blood pressure—becomes stiff. This is the number one cause of heart failure in women. DD may have to do with women’s smaller blood vessels and declining energy levels in the heart. Fortunately, the latter can be combated by taking the “Awesome Foursome,” my name for the four supplements that are crucial for cellular energy production and important for ensuring that your heart has the raw materials necessary to maximize its efficiency.

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Painkillers

Daily doses of non-aspirin painkillers, such as extra-strength acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil and Motrin), increase the risk of developing high blood pressure. A 2005 Harvard study found that women who took more than 500 mg of acetaminophen daily (the amount in one extra-strength tablet) had a 93 to 99 percent greater risk of developing hypertension within three years than women who took less. Likewise, women who took more than 400 mg a day of over-the-counter NSAIDs (the equivalent of two ibuprofen) had a 60 to 78 percent greater risk for hypertension than women who took less than that amount.

If you take painkillers regularly, be sure to inform your doctor and find out about safer medications. I recommend Traumeel, a homeopathic remedy available in health food stores or online at www.traumeel.com. You can buy it as a topical cream or sublingual tablet, and it works great for various muscle aches and pains—without the potentially devastating effects on blood pressure.

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Emotions

Years ago, I conducted a fascinating co-ed study on stress and the heart with my cardiac patients. Before and after a workshop, I measured each person’s blood pressure, as well as the level of stress hormones in their urine. I found that the women who expressed their emotions and networked with one another during the workshop had lower levels of stress hormones and lower blood pressures. This is a good point to remember—the value of spending time with other women, and of talking to moms, sisters, and girlfriends about health and other life issues. You may be able to lower your blood pressure by re-establishing or strengthening some of these valuable connections.

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More Dr. Sinatra Advice on Understanding Blood Pressure

What is a healthy blood pressure reading? Learn what your blood pressure numbers should be.

How do you know if your blood pressure reading is accurate? Find out the important steps you need to take to get the most accurate blood pressure reading.

Do you have white coat hypertension? Discover how this common condition could be causing your high blood pressure readings.