Monitoring your blood pressure

High Blood Pressure (Hypertension) in Women

Three of every four women with high blood pressure know they have it. Yet fewer than in one in three are controlling it. All women can and should take steps to control their high blood pressure.

This is especially important for women who have heart disease. When blood pressure is lowered, the heart does not work as hard. Women who have had a heart attack are less likely to have another if they reduce their high blood pressure.

Older women are particularly likely to develop high blood pressure. More than half of all women over age 60 have it. And you may be surprised to learn that many women take blood pressure drugs but still have high blood pressure. This is especially true for older women. To prevent stroke, heart attack or heart failure, blood pressure must be controlled to below 140/90.

Ultimately, the best medicine is prevention and early detection. At Rush, patients have access to the expertise of the Heart Center for Women along with the world’s premier hypertension clinic and a state-of-the art Preventive Cardiology Center.

What is blood pressure?

Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider, is the force of the blood pushing against the artery walls. Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts.

Two numbers are recorded when measuring blood pressure. The higher number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The lower number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood. Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of the blood.

High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), high blood pressure for adults is defined as:

• 140 mm Hg or greater systolic pressure
  
  and
  
  
• 90 mm Hg or greater diastolic pressure
  

In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:

• 120 mm Hg – 139 mm Hg systolic pressure
  
  and
  
  
• 80 mm Hg – 89 mm Hg diastolic pressure
  

The new NHLBI guidelines now define normal blood pressure as follows:

• Less than 120 mm Hg systolic pressure
  
  and
  
  
• Less than 80 mm Hg diastolic pressure
  

Blood Pressure Categories for Adults

Source: National High Blood Pressure Education Program

The above categories are for those 18 and older not on a high blood pressure drug and with no short-term serious illness.

*If your systolic and diastolic pressures fall into different categories, your overall status is the higher of the two categories.

These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment. A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.

• If you smoke or use tobacco, stop
• Become more physically active
• Choose foods low in salt and sodium
• Limit your alcohol intake
• Lose weight if you are overweight
• If you’ve been prescribed medication to control your blood pressure, take it consistently as directed.

What are the risk factors for high blood pressure?

High blood pressure can occur in anyone, but is particularly prevalent in:

• persons with diabetes mellitus, gout, or kidney disease.

• African-Americans (particularly those who live in the southeastern United States).

• persons in their early to middle adult years; men in this age group have higher blood pressure more often than women in this age group.

• persons in their middle to later adult years; women in this age group have higher blood pressure more often than men in this age group (more women have high blood pressure after menopause than men of the same age).

• middle-aged and elderly people - more than half of all Americans age 65 and older have high blood pressure.

• persons whose parents or grandparents have/had high blood pressure.

• obese people.

• heavy drinkers of alcohol.

• women who are taking oral contraceptives.

How does blood pressure increase?

The following may contribute to an increase in blood pressure:

• being overweight
• excessive sodium intake
• a lack of exercise and physical activity

How is high blood pressure controlled?

Many people can control high blood pressure by:

• choosing foods that are low in sodium (salt).
• choosing foods low in calories and fat.
• choosing foods high in starch and fiber.
• maintaining a healthy weight, or losing weight if overweight.
• limiting serving sizes.
• increasing physical activity.
• practicing moderation if consuming alcoholic beverages.

However, other people must take daily medication to control hypertension. People with hypertension should routinely have their blood pressure checked and be under the care of a physician.

Hormone replacement therapy update

To learn more about women's health, and specifically hormone replacement therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) launched the Women's Health Initiative (WHI) in 1991. The hormone trial had two studies: the estrogen-plus-progestin (HRT) study of women with a uterus and the estrogen-alone (ERT) study of women without a uterus. Both studies were concluded early when the research showed that hormone replacement did not help prevent heart disease and it increased risk for some medical problems.

The WHI recommends that women follow the Food and Drug Administration (FDA) advice on hormone (estrogen-alone or estrogen-plus-progestin) therapy. It states that hormone therapy should not be taken to prevent heart disease.

These products are approved therapies for relief from moderate to severe hot flashes and symptoms of vulvar and vaginal atrophy. Although hormone therapy is effective for the prevention of postmenopausal osteoporosis, it should only be considered for women at significant risk of osteoporosis who cannot take non-estrogen medications. The FDA recommends that hormone therapy be used at the lowest doses for the shortest duration needed to achieve treatment goals. Postmenopausal women who use or are considering using hormone therapy should discuss the possible benefits and risks to them with their physicians.

Click here to view the
Online Resourcespage of this Web.