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 heart attack or stroke. Untreated high blood pressure is also associated with lower cognitive function.

Women without hypertension may develop it during pregnancy, which is called gestational hypertension. Both gestational and pre-existing high blood pressure during pregnancy may lead to various complications including preeclampsia, eclampsia, stroke and preterm birth. High blood pressure is one of the leading causes of maternal mortality in the United States, 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 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 risk factors that cannot be changed.

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

The prevalence of high blood pressure is higher among:

• Women ages 35-44 compared with those ages 25-34 and 18-24. 
• Non-Hispanic Black women compared with 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 compared with those with a household income of $75,000 or more.

High blood pressure may be managed 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 suggested by a doctor. Women with high blood pressure may monitor their blood pressure at home with a home blood pressure monitor.

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

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.

“Cardiovascular Disease: A Costly Burden for America — Projections Through 2035.” American Heart Association CVD Burden Report. American Heart Association, 2017. https://www.heart.org/-/media/files/get-involved/advocacy/burden-report-consumer-report.pdf.

Nilsson, Peter M., Margus Viigimaa, Aleksander Giwercman, and Renata Cifkova. “Hypertension and Reproduction.” Current Hypertension Reports 22, no. 4 (March 13, 2020): 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. “Short-Term Costs of Preeclampsia to the United States Health Care System.” American Journal of Obstetrics and Gynecology 217, no. 3 (September 1, 2017): 237-248.e16. https://doi.org/10.1016/j.ajog.2017.04.032.

U.S. Department of Health and Human Services. “The Surgeon General’s Call to Action to Control Hypertension.” Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General, 2020. https://www.hhs.gov/sites/default/files/call-to-action-to-control-hypertension.pdf?utm_medium=email&utm_source=govdelivery.

Yano, Yuichiro, Michael Griswold, Wanmei Wang, Philip Greenland, Donald M. Lloyd-Jones, Gerardo Heiss, Rebecca F. Gottesman, and Thomas H. Mosley. “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, no. 15 (August 7, 2018). https://doi.org/10.1161/JAHA.118.009578.