High blood pressure, also called hypertension, is a serious health condition that affects millions of women. Many women don’t know they have it because symptoms are often silent. That’s a problem, because by the time high blood pressure causes noticeable symptoms, it can also trigger major health issues.
Understanding hypertension can help you know how to protect your heart and overall health. Here’s what to know about why it’s often missed, signs to watch for and how you can manage it.
Why is high blood pressure often missed in women?
High blood pressure is often called the silent killer because it usually doesn’t cause symptoms. But for women, it’s even more likely to be missed. If it does cause symptoms, they can be blamed on other issues or brushed off.
“Symptoms can be subtle or mistaken for other conditions like stress or menopause. Women tend to under-report their symptoms and may have less-common symptoms like fatigue, anxiety or headaches," said Aye Thandar Win, MD, a cardiologist with Banner Health who specializes in caring for women.
"These symptoms are not always associated with hypertension, and people will tend to blame the blood pressure being high as 'white coat syndrome' (when blood pressure rises in a medical setting because the patient is nervous)," Dr. Win said.
Hormonal factors can also play a role — changes from birth control, pregnancy or menopause can affect your blood pressure. Research shows that women, especially women of color, are more likely to be misdiagnosed or undertreated for heart-related conditions including hypertension.
“Hypertension in women is often underdiagnosed due to societal and medical biases, so self-advocacy is important," Dr. Win said. "And Black women face a higher risk compared to other racial groups due to genetic and socioeconomic factors."
What are the risk factors for hypertension in women?
While some risk factors for high blood pressure are the same for everyone, there are a few that are more common or unique to women:
- Aging and menopause: Your blood pressure tends to rise after menopause. "That’s due to the decline in estrogen, which offers some cardiovascular protection," Dr. Win said.
- Pregnancy complications: Conditions like preeclampsia or gestational hypertension can increase your long-term risk of high blood pressure.
- Oral contraceptives: Certain birth control pills may raise your blood pressure. You should check your blood pressure regularly if you take birth control pills.
- Family history: If high blood pressure runs in your family, your risk is higher.
- Lifestyle factors: Stress, a poor diet, lack of exercise, smoking and alcohol use can all contribute.
- Socioeconomic factors: “Lack of access to health care and healthy food disproportionately affect women, especially in marginalized communities," Dr. Win said.
What signs and symptoms should women watch for?
Most people with high blood pressure don’t feel any different. This is why it’s so important to have your blood pressure checked regularly, even if you feel fine.
"It is crucial to check blood pressure on both arms the first time it’s measured," Dr. Win said. “There can be a difference between the two arms. Whichever is the higher blood pressure is your true blood pressure."
If your blood pressure is very high, you might notice some warning signs. They can include:
- Frequent headaches
- Blurred vision
- Dizziness
- Fatigue
- Chest pain or discomfort
- Shortness of breath
- Nosebleeds
- A pounding sensation in your chest or ears
- A sense of anxiety
If you notice any unusual or persistent symptoms, contact a health care provider right away for a blood pressure check.
How does high blood pressure affect women’s health?
Over time, uncontrolled high blood pressure puts stress on your heart, blood vessels and organs. It can lead to major health issues that can be deadly. These include:
- Heart disease and heart attack
- Stroke
- Kidney damage
- Vision loss
"Another lesser-known aspect is that women with hypertension are at a higher risk of developing heart failure with preserved ejection fraction, a condition where the heart pumps normally but is too stiff to fill properly. This condition is more common in women than men," Dr. Win said.
If you are pregnant or planning to become pregnant, high blood pressure can increase the risk of complications for both you and your baby. It can also raise your risk for heart problems later in life.
How can women manage high blood pressure?
High blood pressure is manageable — and sometimes even reversible — with the right care.
Lifestyle changes
These changes are important for your heart health:
- Eat a heart-healthy diet: Focus on fruits, vegetables and whole grains. Limit sodium, added sugars and processed foods. The DASH diet is a good option.
- Stay active: Aim for at least 30 minutes of moderate exercise most days. Include both strength training and cardio exercises.
- Quit smoking and limit alcohol: These habits can raise your blood pressure.
- Get enough sleep: Aim for at least seven hours per night.
- Find healthy ways to manage stress: Try techniques like meditation or yoga.
Medication
"These lifestyle changes may not be enough for some women, so medications may be necessary," Dr. Win said. There are several types of blood pressure medicines available. Your provider will help you choose one that works best for you with fewer side effects.
"New research also suggests that women may respond differently to certain medications, so personalized treatment plans are important," Dr. Win said.
Monitoring your blood pressure regularly and having consistent checkups are important to help keep hypertension under control.
When should you talk to your health care provider about blood pressure?
Even if you feel fine, regular blood pressure checks can catch problems early. "Women should insist on regular blood pressure checks, especially during life transitions like pregnancy or menopause," Dr. Win said.
You should reach out to your health care provider if:
- You haven’t had your blood pressure checked in over a year.
- You’ve had high readings in the past.
- You’re pregnant, planning to become pregnant or in menopause.
- You have a family history of high blood pressure, heart disease or stroke.
Why choose Banner Health for hypertension care?
At Banner Health, we offer care designed with women in mind. Our team includes primary care providers, heart specialists and women’s health experts who can work together to support your health goals.
We provide:
- Personalized treatment plans tailored to your needs
- Help with lifestyle changes and medications
- Regular monitoring and follow-up care
With the right support, you can lower your risk of high blood pressure and feel your best. "Open conversations with health care providers can lead to better outcomes," Dr. Win said. Schedule an appointment with an expert at Banner Health today.
