How Hypertension Affects Women

Hypertension is a significant health problem for many Americans. About 70 million adults in the United States, approximately one in three Americans, have hypertension. Only slightly more than half of Americans with high blood pressure have good control. Hypertension is a chronic disease that often results in damage to the heart, brain, blood vessels, and other organs, including the kidneys.

Doctor showing woman test results

Eva Katalin Kondoros / Getty Images

What the Numbers Mean

The top number represents your systolic blood pressure, which is a measurement of the pressure in your blood vessels when your heart beats. When your heart is resting between beats, your blood pressure is lower. This is represented by the bottom number, the diastolic blood pressure.

Are You at Risk?

Many women consider themselves immune from hypertension. Although it's true that the risk of hypertension is lower in women compared to men, that advantage disappears when women reach menopause. After menopause, women lose the protective effect of estrogen as levels decline. In fact, women have a greater risk of hypertension than men beginning at the age of 65. Women can also develop hypertension before menopause, even though they are at reduced risk.

It's important to monitor blood pressure throughout adulthood since high blood pressure is usually unaccompanied by signs and symptoms until the damage to organs like the heart or kidneys has already occurred. Hypertension is known as a "silent killer," so it's critical to remain alert.

Women Have Gender-Specific Risk Factors

Oral contraceptives can increase blood pressure in some women. You should be certain your healthcare provider measures your blood pressure regularly and records it in your medical record. Smoking increases the risk even more. If you are considering taking an oral contraceptive pill and you smoke, be sure to discuss the increased risk with your practitioner. Women who are age 35 or older and smoke should not use certain oral contraceptives.

Women Have a Higher Percentage of Body Fat Compared to Men

Women have a higher percentage of body fat, which is a risk factor for hypertension. Fat that accumulates deep in the abdomen, known as visceral fat, is linked to hypertension, high cholesterol, heart disease, and insulin resistance. In fact, the identification of metabolic syndrome, which is characterized by central obesity, elevated triglycerides, and high blood pressure, has led researchers to explore this link carefully. Diets like the DASH diet have been demonstrated to decrease blood pressure. In addition to cutting calories, the DASH diet reduces salt consumption, another factor in blood pressure control.

Pregnancy When You Have Hypertension

If you have hypertension and you're taking medication, discuss your condition with your healthcare provider before becoming pregnant. Pregnancy can affect your blood pressure and put you and your developing baby at risk. There are also certain medications that can be dangerous to mother and baby during pregnancy, including angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs). It's important to stop these medications before you become pregnant, but don't stop any prescribed medication without consulting your healthcare provider. If you carefully follow the recommendations of your practitioner to manage your blood pressure, you can remain healthy during your pregnancy and you can deliver a healthy infant.

Gestational Hypertension

It's not unusual for women without any history of high blood pressure to develop hypertension during pregnancy. This is one reason that prenatal care is so important for all expectant mothers.

Hypertension that develops after 20 weeks of pregnancy is called gestational hypertension. It usually resolves after delivery. It occurs in up to 8% of women who are pregnant, and most of the women who develop gestational hypertension are in their first pregnancy. 

Gestational hypertension can develop into preeclampsia, a condition that can result in harm to the placenta and fetus, in addition to potentially causing damage to the mother's organs, including the kidney, liver, and brain. It is diagnosed when a woman has elevated blood pressures (140/90 mmHg or above) and more than a certain amount of protein in her urine.

Preeclampsia usually develops after the 20th gestational week. Some risk factors are high blood pressure before pregnancy; obesity; age under 20 years or over 40 years; multiple gestation (twins, etc.); and a history of preeclampsia in a prior pregnancy.

For those at high risk, daily low-dose aspirin may be recommended to help prevent preeclampsia and its related complications. It is recommended that this be started after 12 weeks, but preferably by 16 weeks of pregnancy.

Women who do develop preeclampsia may experience symptoms like swelling and sudden weight gain, changes in vision, and headache. If preeclampsia gets severe or if eclampsia develops, the baby may need to be delivered immediately to prevent life-threatening complications. Preeclampsia raises a woman's risk of developing hypertension in the future.

While hypertension is a serious condition, lifestyle changes such as following a healthy diet and exercising can reduce your risk of developing this condition and improve your control if you do.

If you do have hypertension, taking your prescribed medications is also an important tool for controlling your condition.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Abramson BL, Srivaratharajah K, Davis LL, Parapid B. Women and hypertension: Beyond the 2017 guideline for prevention, detection, evaluation, and management of high blood pressure in adults. American College of Cardiology.

  2. MedlinePlus. Estrogen and progestin (oral contraceptives).

  3. Kattah AG, Garovic VD. The management of hypertension in pregnancyAdv Chronic Kidney Dis. 2013;20(3):229-239. doi:10.1053/j.ackd.2013.01.014

  4. U.S. Preventive Services Task Force. Aspirin use to prevent preeclampsia and related morbidity and mortality: U.S. Preventive Services Task Force recommendation statement.

By Karen Shackelford, MD
Karen Shackelford, MD, is an emergency medicine physician with years of experience helping patients dealing with blood pressure issues.