Is Hypertension – the ‘Silent’ Lady Killer?

Are women less susceptible to hypertension?

Among the many misconceptions, that one has surrounding women, this is one myth that needs to be busted right now before it is too late – that high blood pressure rarely affects women or that women are not prone to heart attacks. According to the World Health Organization, hypertension is the most common risk factor for non-communicable diseases (NCDs) worldwide and yet still the neglected one. The latest National Family Health Survey-5 (2019-21) data which surveyed women and men above the age of 15 years on various key indicators, showed that 21% women have hypertension while 4 in 10 are close to developing high blood pressure. Hypertension is a key factor in NCDs which account for more than 65% of deaths in India.

Though these numbers are slightly better than men, but the situation deteriorates with age and hormonal changes. Issues like pregnancy, pregnancy prevention (birth control) and menopause can increase the risk of developing high blood pressure. Infact some women who have never had high blood pressure develop it while they are pregnant. Risks of hypertension increases with age but for women the risks increases with menopause.

Young women are protected from developing hypertension, in part, by endogenous estrogen which slowly fades after menopause. As women age, they become more likely to develop hypertension and the associated cardio-vascular outcomes.

What women and young adults tend to neglect is monitoring of one’s blood pressure. However, this is the first step to avoid heart attacks and stroke as high blood pressure is usually unaccompanied by signs and symptoms until the damage to organs like the heart or kidneys has already occurred.

While hypertension is a serious condition, lifestyle changes such as following a healthy diet and regular exercising can reduce your risk of developing this condition and improve your condition.

As a gynaecologist & obstetrician having served in rural and semi-urban districts of Nagpur, I have noticed that hypertension which can be easily monitored at any primary health care centre (PHCs) is largely undetected because of lack of awareness among the population. More and more patients should be encouraged by the government and civil society to visit their nearest PHCs for regular monitoring of their blood pressure and regular medication. Community based health workers like ASHA workers play a crucial role in meeting this challenge of undetected, untreated and uncontrolled hypertension in India especially among rural women.

They are trained to improve early detection, encourage lifestyle modifications and ensure adherence to treatment. They can also help prevent hypertension by advising appropriate lifestyle modifications in those who have a high normal BP.

Socio-cultural norms encourage women to be active in India even if they are not working outside. Weight loss strategies may be beneficial in older hypertensive women with obesity and midlife weight gain. Along with weight loss strategies one should also take care of dietary changes and lifestyle modifications. Regular exercises, avoiding high fat, salt and sugar and ultra-processed foods will help in maintaining proper blood pressure. Women in India tend to neglect their health and do not go for regular check-ups. If you do have hypertension, taking your prescribed medications is also an important tool for controlling your condition.

Smoking and alcohol also increases the risk even more. If you smoke and you are considering taking an oral contraceptive pill, be sure to discuss the increased risk with your practitioner.

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