Women’s Heart Health: How to Talk to Your Doctor About Hypertension

Hypertension is the medical term for high blood pressure. Many women only think about their blood pressure when they’re at their health care provider’s office having it measured. But if left untreated, high blood pressure can lead to stroke, heart attack, aortic dissection, heart disease, and other chronic diseases.

When Should Women Start Thinking About High Blood Pressure?

When should women start to think about hypertension? It’s never too early, says Malamo Countouris, MD, a cardiologist at UPMC Heart and Vascular Institute specializing in women’s cardiovascular disease.

“At the Magee-Womens Heart Center, we see a lot of younger women with high blood pressure, particularly related to pregnancy,” Dr. Countouris says. “So, I recommend that women start talking about blood pressure at about age 20, when they are transitioning out of pediatric care into adult health care.

“At that age, women should have their blood pressure checked at least yearly at their annual visit. And if they’re pregnant or have another health condition, then they should have it checked even more often.”

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What is Considered Hypertension?

The American College of Cardiology and the American Heart Association together publish guidelines for hypertension management. Their guidelines say:

  • Normal blood pressure is below 120/80 mmHg.
  • Stage 1 hypertension is blood pressure at or above 130/80 mmHg.
  • Stage 2 hypertension is blood pressure at or above 140/90 mmHg.

Dr. Countouris says doctors do not make the diagnosis of hypertension based on a single high blood pressure reading alone. Instead, it’s based on an average.

“We might have the person get a daily blood pressure every day over one week and then average those pressures to get a more accurate level,” she says.

Many things can elevate blood pressure readings, such as stress, anxiety, and physical exertion. Just traveling to the doctor’s office for an appointment can cause a higher reading than normal. In addition, some people get the white-coat effect — a higher blood pressure reading in a medical setting than at home. This can lead to an inaccurate blood pressure.

One high blood pressure reading doesn’t always warrant treatment. However, periodic blood pressure spikes also can be a warning sign of developing hypertension.

Most cases of hypertension are silent. This means that blood pressure rises slowly over time, and you may not notice any changes. However, a sudden spike in blood pressure could cause you to feel chest pain, headache, shortness of breath, and/or swelling. These are signs that you need to call your doctor right away.

Risk Factors for Hypertension in Women

Three key groups of women have the highest risk of developing high blood pressure. Getting regular blood pressure checks can be especially important for women in these groups, which include:

  • Women with a family history of hypertension, who may develop high blood pressure at a younger age.
  • Women who have a history of preeclampsia or gestational hypertension with a prior pregnancy.
  • Post-menopausal women, whose decreasing estrogen levels may cause hypertension.

Other hypertension risk factors

Other factors that could increase your risk of high blood pressure include:

  • A high-salt diet.
  • Obesity.
  • Sleep apnea.
  • Smoking.
  • Chronic kidney disease.
  • Diabetes.
  • A history of autoimmune disorders, such as lupus or rheumatoid arthritis.

How to Take a Blood Pressure Reading at Home

Here are the best practices for taking a blood pressure reading yourself:

  • Sit comfortably in a chair with your back supported and your feet uncrossed and flat on the floor. Stay like this for five minutes before taking the reading. Your arm should be supported at about heart level (mid-chest).
  • Place the blood pressure cuff on the upper arm and take the reading. An automatic upper arm cuff often is best for taking a reading, but the manual type also is accurate.
  • If you use a wrist cuff, have your blood pressure reading validated at your next doctor’s appointment. Wrist cuffs are less accurate than arm cuffs.

If your blood pressure is higher than the normal range of 120/80 mmHg, talk to your primary care provider.

Women are undertreated for cardiovascular risk factors. So Dr. Countouris cautions women not to ignore their risk or think their blood pressure elevation is a fluke.

“Know your numbers and bring up any elevated blood pressure readings with your doctor,” she adds.

How to Manage High Blood Pressure

There are many different types of medications to control hypertension, along with lifestyle changes.

Dr. Countouris says many of the younger people she sees in the heart program are seeking cardiovascular care because of pregnancy-related high blood pressure. Medication can safely control blood pressure even during pregnancy and breastfeeding. Your health care provider can prescribe the right hypertension medication for you based on your needs and medical history.

In addition, there are many small lifestyle changes you can make to improve your blood pressure. Some of the easiest include:

  • Getting regular exercise.
  • Maintaining a healthy weight.
  • Eating a heart-healthy diet.
  • Quitting smoking.
  • Getting good sleep.

Three Key Takeaways

Dr. Countouris would like women to remember these three points when considering their blood pressure readings:

  • It’s never too early to start monitoring your blood pressure.
  • Know your numbers and monitor your blood pressure over your lifetime.
  • Talk to your health care provider about taking medication for hypertension if your numbers are high.

“Talking to your doctor about blood pressure and treating your hypertension with medication are important ways you can take part in your own cardiovascular health,” Dr. Countouris says.

The UPMC Heart and Vascular Institute provides world-class care for hypertension and other cardiovascular conditions. To find a location near you, visit our website.

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.