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Heart disease is the leading cause of death for women in the U.S, and high blood pressure greatly increases your risk of developing the condition. Understanding the causes of hypertension in women can help you make informed decisions about healthcare, diet and exercise so you can lower your blood pressure and the likelihood of health complications.

Prevalence of high blood pressure in women

Roughly 44% of women in the U.S. have high blood pressure, according to the U.S. Centers for Disease Control and Prevention. Although the percentage of women who have hypertension is lower compared to men, hypertension is still a major health concern. Only one out of every four people with hypertension has the condition under control, meaning many women are at an increased risk of serious health complications like heart disease and stroke.

What causes high blood pressure in women?

High blood pressure in women can have many causes. Often, lifestyle factors play a role. Some behaviors that can contribute to hypertension include:

  • Diet high in sodium and low in potassium
  • Lack of physical activity
  • Drinking more than one alcoholic beverage per day
  • Smoking

Other causes of high blood pressure in women include:

  • Family history of high blood pressure
  • Obesity
  • Diabetes
  • Hypothyroidism and hyperthyroidism
  • Sleep apnea
  • Kidney disease
  • Prescription and over-the-counter medications
  • Caffeine
  • Hormonal changes related to pregnancy and menopause

What is considered high blood pressure for a woman?

The American Heart Association defines high blood pressure for men and women in the same way:

  • Elevated blood pressure: systolic readings of 120-129 and a diastolic reading of less than 80
  • Stage 1 high blood pressure: systolic readings of 130-139 or a diastolic reading of 80 to 89
  • Stage 2 high blood pressure: systolic readings of 140 or higher or a diastolic reading of 90 or higher
  • Hypertensive crisis: systolic readings over 180 and/or diastolic readings over 120

Symptoms of high blood pressure in women

In women who aren’t pregnant, high blood pressure is unlikely to cause any symptoms unless levels become elevated enough to cause a hypertensive crisis. High blood pressure is thought of as a silent killer because the lack of symptoms means most people don’t know they have it.

Regular preventative visits with your primary care provider is the best way to screen for hypertension. If you’re at risk due to your family background or another factor, your doctor may have you monitor your blood pressure at home.

Symptoms of a hypertensive crisis in women include:

  • Chest pain
  • Severe headache
  • Blurred vision
  • Confusion
  • Nausea and vomiting
  • Anxiety
  • Shortness of breath
  • Seizures

If you experience any of these symptoms, seek emergency medical attention.

Hormonal causes of high blood pressure in women

Changes in levels of the sex hormone estrogen may contribute to hypertension during various stages in a woman’s life. Having other risk factors for high blood pressure makes you more likely to experience high blood pressure due to hormonal changes.

High blood pressure and menstruation

There is no evidence to suggest that menstruation causes high blood pressure. Your blood pressure may fluctuate slightly during various stages of your menstrual cycle, but not enough to result in hypertension on its own.

One study did find that women who began menstruating at an early age were more likely to develop high blood pressure later in life, but more research is needed to verify the findings. Another study conducted by researchers at the University of Massachusetts found an association between severe premenstrual syndrome (PMS) symptoms and hypertension. However, the study didn’t prove that PMS causes high blood pressure.

Can menopause cause high blood pressure?

Rates of hypertension in women are highest after menopause due to the sharp drop in estrogen levels that occurs. Other risk factors for hypertension like an unhealthy diet and lack of exercise can make a woman more likely to have high blood pressure after menopause. In some cases, hormone replacement therapy (HRT) may cause spikes in blood pressure. 

High blood pressure and pregnancy

High blood pressure develops in one out of every 12 to 17 pregnancies in the U.S. Developing high blood pressure during pregnancy can lead to serious health complications for both the mother and baby, but with close monitoring and treatment, a successful, safe pregnancy with hypertension is possible.

High blood pressure before pregnancy

Women who have high blood pressure before pregnancy may worry about whether they can safely have a baby. Having high blood pressure prior to pregnancy does increase the risk of pregnancy-related health complications. However, the condition shouldn’t prevent someone from getting pregnant.

If you plan to become pregnant, work with your primary care provider to get your blood pressure levels under control with medication that is safe to use during pregnancy. Make healthy lifestyle changes ahead of time to help keep your blood pressure in check. Once you become pregnant, your doctor will likely want you to monitor your blood pressure at home and have regular checkups.

Dangers of high blood pressure during pregnancy

If your doctor says you have chronic hypertension, gestational hypertension or preeclampsia, following their advice and instructions is the best way to ensure a good outcome. Keep all of your prenatal appointments and contact your doctor immediately if you develop any symptoms of preeclampsia or if preeclampsia symptoms worsen.

Women who develop high blood pressure during pregnancy can still successfully deliver a healthy baby. If your doctor says you have chronic hypertension, gestational hypertension or preeclampsia, following their advice and instructions is the best way to ensure a good outcome. 

High blood pressure during pregnancy can cause a number of complications:

  • Preeclampsia and eclampsia, which can cause kidney or liver damage
  • Stroke
  • Need for induced labor
  • Placental abruption (the placenta becoming separated from the wall of uterus)
  • Preterm delivery
  • Low birth weight

What causes high blood pressure during pregnancy?

The causes of high blood pressure during pregnancy aren’t fully understood. The body’s volume of blood increases considerably during pregnancy, and this could play a role in the onset of hypertension during pregnancy. Risk factors for high blood pressure during pregnancy include:

  • Chronic high blood pressure prior to pregnancy
  • Kidney disease
  • Obesity
  • Being over age 40
  • Pregnancy with more than one baby
  • Family history of high blood pressure during pregnancy
  • Diabetes
  • Lupus

High blood pressure symptoms in pregnancy

Signs and symptoms of preeclampsia include:

  • Swelling of the hands and face
  • Persistent headache
  • Vision disturbances such as blurred vision or seeing spots
  • Pain in the shoulder or upper abdomen
  • Nausea and vomiting during the second half of pregnancy
  • Sudden weight gain beyond what is expected due to the growth of the baby
  • Trouble breathing

High blood pressure in early pregnancy

High blood pressure that occurs in early pregnancy is usually considered chronic hypertension. Often, women who develop high blood pressure before the 20th week of pregnancy most likely had hypertension prior to pregnancy and didn’t know.

Blood pressure levels sometimes decline during the first half of pregnancy, so doctors may closely monitor you at first. If levels don’t fall or they become higher, your doctor may prescribe a blood pressure medication that is safe for pregnant women.

High blood pressure in mid-pregnancy

An increase in blood pressure that occurs after the 20th week of pregnancy is called gestational hypertension. Your doctor may diagnose you with hypertension if:

  • Your systolic blood pressure is 140 mm Hg or higher

And/or

  • Your diastolic blood pressure is 90 mm Hg or higher

If you develop gestational hypertension, your doctor will monitor you closely for signs of preeclampsia.

High blood pressure in late pregnancy

High blood pressure that develops during late pregnancy is often diagnosed as preeclampsia. This serious medical condition can impact all of the organs and cause serious damage to the liver and kidneys.

High blood pressure during labor

Women who have high blood pressure require close monitoring during labor. You may be given intravenous (IV) magnesium during labor and for 24 hours after to reduce your risk of seizures due to preeclampsia.

High blood pressure after giving birth

Postpartum preeclampsia is the term for high blood pressure that arises after giving birth. In most cases, women develop the condition within the first 48 hours of giving birth, but it can happen up to six weeks after. 

High blood pressure after a C-section

Women who undergo a C-section can also develop postpartum preeclampsia. It may happen within the first 48 hours following the procedure or up to six weeks later.

Treating high blood pressure and preeclampsia

Women with preeclampsia often need to undergo induced labor and have their babies early. Normally, doctors try to wait until the 37th week of pregnancy for induction. However, earlier delivery may be necessary to prevent health complications.

Can you have preeclampsia without high blood pressure?

Almost all women with preeclampsia develop high blood pressure. A paper published in 2017 by a researcher at the University of Tennessee describes a woman who developed the condition without an increase in blood pressure, but cases like these are very rare.

High blood pressure after pregnancy

For most women, preeclampsia and gestational hypertension resolve within 12 weeks of labor or a C-section. Women diagnosed with chronic hypertension may require ongoing monitoring and treatment for high blood pressure.

Sometimes, in addition to blood pressure medication, anti-seizure medications and blood thinners are necessary for women with postpartum preeclampsia. If you have chronic hypertension, your doctor will likely discuss making healthy lifestyle changes to complement the actions of blood pressure medication.

If you’re nursing, notify your doctor so they can prescribe a medication that is safe for your baby.

How to prevent high blood pressure during pregnancy

While you may not be completely able to prevent high blood pressure during pregnancy, following these tips can help to reduce your risk of complications:

  • Visit your doctor as often as recommended
  • Exercise regularly, choosing physical activities that your doctor confirms are safe for you
  • Eat a well-balanced diet rich in whole grains, fruits and vegetables and lean protein
  • Avoid salt and processed foods
  • Don’t smoke or drink alcoholic beverages

Forward delivers one-to-one, customized care for women

Our 12-week Healthy Heart program combines monitoring, diet and exercise optimization and medications as needed to help women lower their blood pressure. We act as your primary care provider with one-to-one, customized care that takes into consideration the causes of high blood pressure as well as your habits and customs so that the lifestyle changes we recommend fit your life. Then, we employ ongoing support and biometric monitoring to track your progress toward achieving your heart health goals.

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