Millions of American women harbor a secret even they don't know they carry. It's high blood pressure, an often silent, symptomless condition that can damage blood vessels and overwork the heart, leaving women prey to heart disease, stroke, and premature death. The April 2013 Harvard Women's Health Watch looks at the reasons why so many women don't know their blood pressure and explains how the treatment of high blood pressure has changed.
A woman's risk of developing high blood pressure is extremely high if she lives long enough, says Dr. Deepak Bhatt, professor of medicine at Harvard Medical School and director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital. About 70% of women in their 60s and 70s have high blood pressure (hypertension), and that rises to nearly 80% after age 75.
Over time, living with high blood pressure puts added strain on the blood vessels and on the heart. The added force of blood surging through arteries damages artery walls and encourages the formation of cholesterol-filled plaques. These plaques can lead to the chest pain known as angina as well as to heart attacks and strokes.
Doctors once recommended trying to reduce blood pressure with lifestyle approaches such as diet and exercise for six months before starting medication. "By the time all that was done, it would be a year, potentially, before the blood pressure was under control. That was definitely the wrong approach," Dr. Bhatt says.
Today, doctors consider prescribing medicines such as ACE inhibitors, angiotensin-receptor blockers, and beta blockers much earlier for women whose blood pressure is 140/90 or higher—the threshold for high blood pressure. Which drug is right for a woman depends in part on other health conditions she may have.
Finding the right blood pressure treatment is often a matter of trial and error. If one drug isn't working or is causing side effects, a woman should see her doctor for a re-evaluation. "There's no one-size-fits-all answer. There's a lot of science, some of it new, and a fair amount of art to treating high blood pressure," says Dr. Bhatt.
Read the full-length article: "High blood pressure a silent danger in postmenopausal women"