High Blood Pressure - Women in North Carolina

North Carolina

High blood pressure (hypertension) can damage arteries and lead to heart attack, heart failure, stroke, brain problems and other major organ damage. High blood pressure in midlife is frequently associated with decreased cognitive function. According to the Centers for Disease Control and Prevention (CDC), about 44% of women in the United States have high blood pressure. However, there are often no warning signs or symptoms — approximately 16% of adults with high blood pressure don’t know they have it.

Women without hypertension may develop gestational hypertension during pregnancy. Both gestational and preexisting high blood pressure during pregnancy can lead to complications, including preeclampsia, eclampsia, stroke and preterm birth. High blood pressure is one of the leading causes of maternal mortality 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 risk factors.

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

• Women ages 35-44 than those ages 25-34 and 18-24. 
• Black women compared with 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 incomes of $75,000 or more. 
• Women living in nonmetropolitan areas compared with women in metropolitan areas.

Many people can manage high blood pressure through lifestyle modification and health care support. Effective interventions include eating a healthy diet, increasing physical activity, quitting or not starting smoking, limiting alcohol intake, getting enough sleep, taking blood pressure medication properly and screening every year or as a doctor recommends. A home blood pressure monitor can help individuals track their blood pressure at home.

Women who are prescribed high blood pressure medication should take it as directed by their doctor. 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 medication counseling, synchronizing prescription refills and using assessment tools to identify what gets in the way of patients taking their medication as prescribed and targeting strategies based on the results.

The CDC recommends that women with preexisting 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 for preeclampsia use low-dose aspirin after 12 weeks of gestation as a preventive measure. The American College of Obstetricians and Gynecologists has answers to more frequently asked questions about high blood pressure during pregnancy.

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

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.

Paulose-Ram, Ryne, Qiuping Gu, and Brian Kit. “Characteristics of U.S. Adults With Hypertension Who Are Unaware of Their Hypertension, 2011-2014.” NCHS Data Brief No. 278. Hyattsville, MD: National Center for Health Statistics, April 2017. https://www.cdc.gov/nchs/data/databriefs/db278.pdf.

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.

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.