High Blood Pressure - Women

High Blood Pressure - Women in United States

United States

High blood pressure, also known as hypertension, may cause problems to major organs such as the heart, kidneys, brain and eyes if not treated properly. High blood pressure can also damage blood vessels, which may lead to a heart attack or stroke. Untreated high blood pressure is also associated with lower cognitive function. Approximately 1 in 5 adults with high blood pressure don’t realize they have it because there are no warning signs or symptoms. According to the Centers for Disease Control and Prevention (CDC), about 44% of women in the U.S. have high blood pressure. 

Women without hypertension may develop it during pregnancy, called gestational hypertension. Both gestational and pre-existing high blood pressure during pregnancy may lead to complications, including preeclampsia, eclampsia, stroke and preterm birth. High blood pressure is one of the leading causes of maternal mortality in the U.S. and requires additional management and monitoring, particularly for signs of preeclampsia. 

Risk factors such as smoking, obesity, physical inactivity, poor diet (eating foods high in sodium and low in potassium) and excessive alcohol use can increase the risk of developing high blood pressure. In addition, some research indicates that birth control pills may increase blood pressure among some women. Age and family history are also non-modifiable risk factors.

In 2015, the total direct costs of high blood pressure among all people in the U.S. were $68 billion. By 2035, the total direct costs of high blood pressure in the U.S. could reach $154 billion. In 2012, the total cost of preeclampsia in the U.S. within the first 12 months of delivery was $2.18 billion.

According to America’s Health Rankings data, the prevalence of high blood pressure is higher among:

• Women ages 35-44 than those ages 25-34 and 18-24.
• Non-Hispanic Black women than non-Hispanic white, Hispanic and Asian women.
• Women with less than a college degree; college graduates have the lowest prevalence of high blood pressure.
• Women with an annual household income less than $25,000 than those with a household income of $75,000 or more.
• Women living in non-metropolitan areas than women living in metropolitan areas.

Many people can manage their high blood pressure through lifestyle modification and health care intervention. Effective interventions include reducing dietary sodium intake, increasing physical activity, quitting smoking, taking blood pressure medication and screening every two years or as a doctor suggests. Women with high blood pressure may monitor their blood pressure at home with a home blood pressure monitor.

The CDC recommends women with pre-existing hypertension make a plan for pregnancy with their care provider to ensure appropriate treatment before and during pregnancy. Women are advised to get regular prenatal care early to monitor blood pressure during pregnancy. The U.S. Preventive Services Task Force recommends that women at high risk use aspirin to prevent preeclampsia. Additionally, the American College of Obstetricians and Gynecologists answers frequently asked questions about high blood pressure during pregnancy.

Women recommended for high blood pressure medications should take them as prescribed and make a habit of taking them daily. The Community Preventive Services Task Force recommends pharmacy-based interventions to improve medication adherence for blood pressure control and cardiovascular disease prevention. There is strong evidence that interventions delivered by pharmacists to the community increase the number of patients who take their medications as prescribed. Examples of interventions include assessment tools used to identify adherence barriers, tailored guidance and services such as recommending pillboxes as well as medication-refill synchronization and medication counseling.

Healthy People 2030 has several objectives related to high blood pressure, including reducing the proportion of adults with high blood pressure.

In addition, the Office of the Surgeon General released a Call to Action in 2020, naming hypertension control as a national priority. The report identifies goals and strategies to improve hypertension control across all U.S. populations.

Nilsson, Peter M., Margus Viigimaa, Aleksander Giwercman, and Renata Cifkova. 2020. “Hypertension and Reproduction.” Current Hypertension Reports 22 (4): 29. https://doi.org/10.1007/s11906-020-01036-2.

Stevens, Warren, Tiffany Shih, Devin Incerti, Thanh G. N. Ton, Henry C. Lee, Desi Peneva, George A. Macones, Baha M. Sibai, and Anupam B. Jena. 2017. “Short-Term Costs of Preeclampsia to the United States Health Care System.” American Journal of Obstetrics and Gynecology 217 (3): 237-248.e16. https://doi.org/10.1016/j.ajog.2017.04.032.

Yano, Yuichiro, Michael Griswold, Wanmei Wang, Philip Greenland, Donald M. Lloyd-Jones, Gerardo Heiss, Rebecca F. Gottesman, and Thomas H. Mosley. 2018. “Long-Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study.” Journal of the American Heart Association 7 (15). https://doi.org/10.1161/JAHA.118.009578.