High Blood Pressure: What Women Need to Know

About 11 million Americans with high blood pressure don't know they have the condition. High blood pressure, or hypertension, puts you at risk for heart attack, heart failure and stroke when it's not caught early enough or adequately treated—and the stakes might be even higher for women.

It's not well understood how hypertension develops in women versus men, but research from the Smidt Heart Institute at Cedars-Sinai suggests blood pressure starts rising earlier and advances faster in women. That's why it's critical women pay close attention to their blood pressure, says C. Noel Bairey Merz, MD, 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 said.

Here is what women need to know about blood pressure, and how to monitor and control it.

Women are at risk for health complications related to high blood pressure.

High blood pressure could be even more serious for young women than young men, according to the study findings and ongoing research at Cedars-Sinai.

The study found women's blood vessels age faster than men's, meaning a 30-year-old woman with hypertension may be more likely to develop cardiovascular problems than a man of the same age.

"Our research not only confirms that women have different biology and physiology than their male counterparts, 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," said Susan Cheng, MD, PhD, the study's senior author and director of public health research at the Smidt Heart Institute.

Women should check blood pressure regularly.

Blood pressure should be checked annually—but many young women don't get it measured as often as they should, usually because they see an OB-GYN for primary care, said Bairey Merz.

Women don't have to wait to see a doctor to keep tabs on blood pressure. Bairey Merz encourages women to buy their own blood pressure machines and self-monitor. Home devices are effective and vary in price, with many affordable options available.

Talk to your doctor if you are concerned about your home blood pressure readings, or they consistently exceed 130/80 mm Hg.

Be your own advocate—especially during pregnancy.

When women have their blood pressure measured, some clinicians may dismiss elevated results, Bairey Merz said. This may be particularly true for women who are pregnant: Only about 60% of pregnant women with hypertension receive treatment, according to one study. But women whose blood pressure is controlled to under 130/80 mm Hg have healthier pregnancies, said Bairey Merz.

Arm yourself with facts, including about your own medical history, and be ready to ask questions or get a second medical opinion if needed. While one high reading might not necessarily mean a problem, it could indicate that you should pay closer attention to your numbers.

"Hypertension is underrecognized and undertreated, and likely it's because providers assume all young women are healthy," Bairey Merz says. "There's a common misunderstanding that women are immune to high blood pressure."

Lifestyle changes can help.

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.

Bairey Merz recommends regular exercise and reducing the amount of salt you eat. She points to a Mediterranean-style diet that emphasizes fruits and vegetables, 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 impact blood pressure.

Guidelines could change as more research emerges.

The latest research found gender differences in high blood pressure is observational and isn't enough to warrant new recommendations—at least not yet, Bairey Merz said. More research is urgently needed.

Understanding health differences between the genders is the easiest way to deliver personalized medicine that works better for both women and men.

"We've studied men for 80 years," she said. "Don't you think it's time we study women?"