Women’s Health

Hypertension

Hypertension (HT) is a largely silent disease until its late stages. Nearly 50,000 Americans died in 2002 as a result of HT and it was a major contributing cause of mortality to over 260,000 Americans that year.

As many as 65 Million Americans over the age of 60 have hypertension and one in three adults has the disease! Thirty percent of Americans with hypertension don’t know they have it and 11% of those that have it (and know it) aren’t on any form of therapy. Many women with hypertension are on inadequate therapy and only 1/3 Americans with hypertension are being adequately treated for it!

Hypertension, or blood pressure elevation, occurs in 30-40% of African American women and 20% of white women. The prevalence of this disease rises to over 90% of women after the age of 70.

Hypertension is truly a silent killer. Women may be hypertensive for many years until its cumulative effects are apparent—heart disease, strokes, kidney disease and blindness. Unfortunately most women in this country go untreated. Despite the fact that 90-95% of cases of hypertension are caused by unknown factors, it remains, in most cases, an easily treated condition and responds well to dietary changes, exercise and medications.

How do you diagnose hypertension?

A normal blood pressure reading contains two numbers: a diastolic and systolic reading. Normal diastolic blood pressures are 80 mm Hg or less, while normal systolic readings are 120 mm Hg or less. If you diastolic blood pressure is between 80-90 or if your systolic blood pressure is between 121-138 you are considered pre-hypertensive and you should get medical help to control this mild condition before it worsens. If your diastolic is consistently above 90 and your systolic is consistently above 140 you have hypertension. Many women balk at being told that they have hypertension and quickly point out that they are anxious in doctor’s offices and that they have “white coat syndrome”. Unfortunately, most of them are wrong. I usually point out that if they are hypertensive in a doctor’s office that there are plenty of other aggravating events in their lives that likely make them hypertensive as well—waiting at an intersection for a light to change, arguing with their co-workers, husband and teen-age children are just a few examples. The point is this—no one likes to be told that they are hypertensive. But ignoring the issue only delays treatment and causes damage to one’s heart, brain, kidneys and eyes.

Are all women with hypertension at equal risk for developing disease?

The simple answer is no. Hypertension is just one of many risk factors that can lead to heart attacks, strokes, congestive failure, kidney and retinal (eye) disease. If you have any other risk factors—smoking, obesity, diabetes, underlying kidney disease or elevated cholesterol you need to have any hypertension treated aggressively.

What causes hypertension?

The answer is a complex one. For the most part physicians don’t understand the causes of most cases of hypertension. However we know that blood pressure elevation can be caused by the following:

  • Diets high in salt
  • Diets low in potassium
  • Diets low in fruit, vegetables and dairy products
  • Diets high in fat and cholesterol
  • Moderate drinking (more than 2 beverages per day)
  • Genetic component
  • Lack of physical exercise
  • Kidney disorders
  • Sleep apnea
  • Hypo and hyperthyroidism
  • Adrenal tumors
  • Excessive serum calcium

If I have hypertension can I be helped?

Absolutely! We will ask you to be a partner in your own health care. That means purchasing a home blood pressure cuff , or other monitoring device, to track your own blood pressure and keep a log over an extended period of time. It also means committing to an exercise program, eliminating added salt to your diet, avoiding excess alcohol and well as making a variety of other life-style changes. Additionally, you may require medication to bring your blood pressure under control. Most of the medications that are available today have few if any significant side effects—and many of them are available in generic form which makes them more affordable. You will need to be monitored on a regular basis – every 3 or 4 months in most cases—so that we know that you are maintaining good blood pressure control