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If you wait 20 years, it is too late. Around one in three women have hypertension globally. This reverses in the years after menopause so that after the age of 65, hypertension is more common in women than men. It is a misconception that high blood pressure does not cause symptoms. In fact, symptoms are more pronounced in women but may be mistaken for menopause, anxiety or stress.
Young and middle-aged women with high blood pressure often report palpitations, chest pain, pain between the shoulder blades, headaches, difficulty concentrating, shortness of breath, tiredness, fluid retention, poor sleep, hot flushes and a feeling that their bra is too tight. Hypertension in midlife is more harmful in women than in similarly aged men, and is a stronger risk factor for myocardial infarction, cognitive decline and dementia.
More research is needed before there is any change in treatment guidelines but I expect that within five years the threshold for normal blood pressure will be lower in women than men. Certain life events predispose women to developing hypertension such as having migraines from their teenage years, having two or more miscarriages, hypertension during pregnancy which affects around one in seven pregnant women and preeclampsia a more severe form of hypertension during pregnancy.
Know your blood pressure: measure it at home. When we asked women with preeclampsia to check their blood pressure at home, approximately one in four had hypertension that would have been missed with usual care. When should you start measuring blood pressure and how often? Start yearly monitoring at age 40 if you have hypertension in your family or you had hypertension during pregnancy. Women with preeclampsia should check their blood pressure from that pregnancy onwards at least twice a year.
