High blood pressure in women does have some differences compared to men that are worth pointing out – not least that some doctors seem to treat high blood pressure in women differently! However, apart from situations like hypertension in pregnancy, most of what holds true for men is true for women too.
HEART HEALTH FOR WOMEN:
The three most important things you can do to prevent cardiovascular disease are: Control your blood pressure Control your cholesterol levels Quit smoking So, please visit other sections on this site that can tell you about lifestyle changes, such as diet and exercise, that can help control your blood pressure – in many cases following this advice will keep you from needing medication. There are also sites specific to women’s health that can give additional advice – for an excellent site on stress relief tips check out Stress Management for Women to learn more.
HIGH BLOOD PRESSURE IN WOMEN – THE DIFFERENCES
THE MENOPAUSE
Postmenopausal women are at a higher risk of developing high blood pressure than men of the same age. This is the reverse of the situation with premenopausal women in which men are slightly more at risk of hypertension. Researchers are not sure why, though the protective effect of female hormones is part of the reason.
OLDER WOMEN HAVE MORE TO GAIN FROM GOOD BP CONTROL
A related and important finding is that older women have more to gain than men by reducing their blood pressure if it is raised. One study, published in Hypertension (the Journal of the American Heart Association) found that in women,lowering blood pressure could prevent 36% of serious cardiovascular events such as heart attacks and strokes, compared to only 24% in men.
THE CONTRACEPTIVE PILL
One cause of high blood pressure in women is use of the birth control pill. It does not cause it in all women – you are at greater risk if you are overweight, have a family history of HBP or have had high blood pressure during pregnancy.If you are planning to take the birth control pill, do not be scared off –(millions of women take it safely) but do discuss with your doctor and you should definitely monitor your blood pressure regularly. If you are thinking about this (and you should be!) you can read more about monitors here.
WOMEN HAVE MORE OF SOME RISK FACTORS
Some surveys have found that among people with high blood pressure, more women than men have central obesity and raised cholesterol.
FEWER WOMEN GET THE RECOMMENDED THERAPY
Researchers analysing data from a large survey of Americans found that, for those with cardiovascular conditions (including hypertension) only 20.7 percent of women, compared to 46.6 percent of men, received the recommended therapy for their cardiovascular conditions. This means that it is important that you stay well- informed about high blood pressure so that you will be aware if you are not
receiving the recommended treatment.
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HIGH BLOOD PRESSURE IN PREGNANCY
WELLNESS GUIDE
If you have been diagnosed with hypertension during your pregnancy, or even if you are looking for preventative measures to keep your blood pressure down, here are a number of recommendations to help keep you “calm and collected”.
1.WATER
Drink some water. Then drink some more and then some more. At least 8 cups a day or more if you can. You’ll get to know the washrooms all about town.
2.EXERCISE AND STRETCHING
Active women are less likely to suffer from high blood pressure. For those who are dealing with hypertension already, walking, yoga, tai chi and gentle stretching are beneficial to keep your blood circulating and heart pumping.
3.A HEALTHY DIET
A diet that includes plenty of fresh organic fruits and vegetables will help you feel good about how you are caring for yourself and for your baby. Some special considerations to help alleviate or prevent hypertension include:
a) Load up on the protein. Up your protein intake to 80-100 grams per day. So we are taking about eating A LOT of protein. There are roughly 25 grams of protein in three cups of milk, or four eggs, or two cups of cooked beans, or two ounces of nuts, or four ounces of fish, meat or cheese.
b) Calcium is your friend! 1,000 grams of calcium daily during pregnancy is recommended. `The best source of calcium is seaweed! Other calcium-rich foods include fish, dairy products, almonds, broccoli, bok choy, brazil nuts, collard greens, dandelion greens, eggs, kale, blackstrap molasses, sesame tahini, soybeans, tofu, and sunflower seeds.
c) Potassium. Potato peels and fresh bananas are exceptionally rich in potassium. A banana a day keeps the cramps away.
d) A cucumber a day. Cucumbers are the food most renowned for lowering blood pressure. A whole cucumber per day will also relieve constipation and benefit your kidneys.
e) Other dietary recommendations include taking fish oil, eating large quantities of garlic, and avoiding stimulants such as spicy or peppery foods, black tea, cola drinks, coffee, and nicotine.
4.TEA FOR TWO
Drink nettle or raspberry leaf infusions daily. Other helpful herbal teas (to be taken under the direction of a herbalist) include hops, passionflower, skullcap, and Hawthorn berries.
Making an Herbal Infusion: Use a jar that has a lid and holds at least 4 cups of water. Put one handful of loose leaves (or roots in the case of ginger) and pour boiling water into the jar. Leave for 4 hours or more It’s easy to prepare this before bed and have it ready at room temperature in the morning.
Long steeping extracts all the chlorophyll, as well as the vitamins and minerals. Drink your tea over the course of the day.
If you want to steep a fresh hot cup of tea, leave a teaspoon of herbs in a cup of water for at least 15 minutes.
5.ENJOY REGULAR BATHS.
Adding Epsom salts to your bath allows for magnesium absorption and this often aids in pain relief. Daily swimming in a pool is also recommended.
6.EXPRESS YOURSELF
Emotional stress can raise blood pressure. It is important to express difficult emotions as they arise, as opposed to holding them in. Talk openly to family and friends. Find non-verbal forms of expression (in art, movement, and singing).
7.RELAXATION/MEDITATION/VISUALIZATION
Nothing is as centering and healing as a deep mindful breath. Search out activities or classes that resonate with you, be they prenatal yoga, or mindfulness meditation. Enjoy the journey with an open heart and smile on your face.
Women can also enter pregnancy with pre-existing high blood pressure (essential hypertension).
In both cases, blood pressure is monitored on an ongoing basis. The systolic (the top figure) and the diastolic pressure (the bottom reading) are monitored. Concern will arise if either the systolic or diastolic pressure rises significantly above the woman’s original blood pressure (baseline). A diastolic pressure of over 90-95 is usually considered a cause for concern, particularly if accompanied by upper body edema, protein in the urine, severe headaches, nausea or vomiting, and/or visual disturbances.
Pregnancy Induced Hypertension (PIH) affects 2.5-3% of pregnant women (Redman C, Sargent 2005. Latest Advances in Understanding Preeclampsia. Science 308: 1592-4.) PIH is more commonly experienced by first-time mothers, especially those under 19 and over 40 years old, and those who are obese.
ACUPUNCTURE TREATMENT FOR HIGH BLOOD PRESSURE
Acupuncture is the most commonly used method to treat hypertension during pregnancy in our Toronto Acupuncture clinic. Acupuncture is used to balance and relax the body, and is most successful in combination with lifestyle adjustments – especially regular exercise, stress relief, and a healthy diet.
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From a Chinese Medicine perspective, the appropriate treatment depends on the underlying imbalance that is causing the hypertension. Different imbalances will show different combinations of signs and symptoms in addition to the high blood pressure. An experienced acupuncturist will determine a woman’s pattern of imbalance (in this case some possibilities include Liver Blood deficiency, Liver and Kidney yin deficiency, Spleen Yang Deficiency, Liver Yang Rising) and treat her specific condition.
The Journal of the American Medical Association (JAMA) published a study that reported that consuming sufficient calcium during pregnancy can reduce the risk of PIH and preeclampsia. The researchers found that 1500 – 2000 mg daily of calcium supplementation can lower the risk of PIH by 70% and the risk of preeclampsia by over 60%.
A study on exercise and gestational hypertension concluded that the most active women were 43% less likely to develop pree clampsia than sedentary women.
HOW COMMON IS HIGH BLOOD PRESSURE IN PREGNANCY?
High blood pressure is fairly common in pregnancy, affecting about one mum-to-be in 10.
Your blood pressure is more likely to rise if you were overweight at the start of your pregnancy.
Your midwife will work out your body mass index (BMI) at your booking appointment. A high BMI, of 30 or more, increases your chances of developing high blood pressure by up to four times. So your midwife will want to keep a close eye on you if you’re overweight.
IS HIGH BLOOD PRESSURE IN PREGNANCY SERIOUS?
Most cases of mild or moderate high blood pressure won’t cause any problems for you or your baby.
However, the earlier in pregnancy your blood pressure goes up, the greater your chance of developing pre-eclampsia later on.
High blood pressure is a sign of pre-eclampsia, a condition that influences how well the placenta works. If the placenta is not working as well as it should, it can affect how your baby grows. This is because your baby may not be able to get all the nutrients and oxygen she needs.
Your midwife will test your urine to see if it has protein in it. Having protein in your urine and high blood pressure are both signs of pre-eclampsia.
Your chances of developing pre-eclampsia are also higher if you are very overweight. Having close care from your midwife, especially if you are overweight, means she will pick up any signs of the condition.
The key thing with pre-eclampsia is to catch it early, so that you and your baby can be monitored and treated. You may have very high blood pressure and feel absolutely fine. That’s why it’s important to go to all your antenatal appointments so your midwife can check your blood pressure at each visit.
If your blood pressure is too high, you may be advised to see a hospital specialist. This will be the case whether your blood pressure rose after 20 weeks and you have gestational hypertension, or you had high blood pressure before you became pregnant.
HOW IS HIGH BLOOD PRESSURE IN PREGNANCY TREATED?
Depending on how high your blood pressure is, you’ll be offered extra monitoring, blood tests, urine tests and, possibly, treatment. Blood pressure is only one factor in your health, so you may have scans too to check how your baby is growing.
If you had high blood pressure before you conceived (essential chronic hypertension), your doctor will prescribe medication to keep your blood pressure lower than 150/100.
If you were on medication before you became pregnant, this is likely to have been reviewed when planning your pregnancy or in early pregnancy. It’s also best to keep your salt intake low, as having a lot of salt can push up your blood pressure. Depending on your individual case, your midwife may organise extra antenatal checks for you.
WILL MY HIGH BLOOD PRESSURE AFFECT MY BABY’S BIRTH?
It’s possible to have high blood pressure and have a straightforward birth. But the higher your blood pressure is, the more likely it is that your doctor will offer to start your labour artificially. This is called an induction.
Having an induction also depends on whether your high blood pressure is affecting your baby. Your doctor will discuss your case with you, mentioning any other complications, so that you can come to the right decision for you.
High blood pressure needs frequent monitoring during labour. If your high blood pressure is mild or moderate, you could have it measured hourly. If it is severe, it may need to be continuously monitored.
If you’re taking medication, you’ll need to carry on taking it during labour. Even so, it’s perfectly possible to aim for a straightforward birth, as long as your high blood pressure is well controlled during labour. Your baby will be continuously monitored, though, to make sure he doesn’t become distressed.
Some mums-to-be whose severe high blood pressure doesn’t respond to treatment may be offered an assisted birth. This means a doctor helps your baby to be born using instruments that attach to your baby’s head. This can speed up the second stage of labour.
In some circumstances, where speed is of the essence, you may be offered a caesarean section.
WHAT WILL HAPPEN AFTER MY BABY IS BORN?
Your blood pressure will be monitored at least daily for the first two days after your baby’s birth. It will then be checked at least once three days to five days after the birth.
If your blood pressure was normal before you became pregnant, it will most likely return to normal within a few weeks of your baby’s birth. It’s worth being aware that you’re more likely to develop high blood pressure in a future pregnancy, and later in life.
If it doesn’t return to normal then it’s unlikely you had gestational hypertension. What you have is essential chronic hypertension. This means your blood pressure will carry on being high after your baby is born. If that’s the case, your doctor will probably advise you to keep taking medication to ensure your blood pressure stays at a healthy level.
In most cases, your midwife will advise you about when you need to make an appointment with your GP to review your medication. This will happen before your six-week postnatal check-up. Rest assured if you are breastfeeding, there are many medications for high blood pressure that are also safe for your baby.
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