Women: Hypertension’s Dangerous Gender Bias

Pat Chehab, 68, speaks from the heart when she talks about cardiovascular disease.  And she uses her personal medical history to warn women about the need for early recognition and treatment of hypertension. That’s the message she shares during presentations at Baptist Hospital and South Miami Hospital, where she serves as a volunteer for WomenHeart, a support group for women.

How important is early treatment of hypertension?  Consider this: Fifty years ago, when she was 18, Ms. Chehab was hospitalized for a week after doctors were baffled by her vital signs.  “You just have high blood pressure,” she was told after being released.  And that was the beginning of her life journey with high blood pressure, a health threat that was undertreated for decades.

Finally, around age 50, Ms. Chehab went to a Baptist Health cardiologist who was alarmed by her high blood pressure readings and stress-test results. The concern was warranted.  She needed an emergency bypass surgery to treat three blocked arteries.

That’s just a part of the story she shares when she tells women about the importance of early detection and treatment of high blood pressure. Her message is endorsed by a new study published in the Therapeutic Advances in Cardiovascular Disease, which shows that high blood pressure can be more of a toxic health threat for women than to men.

“Even a little bit of hypertension can be very dangerous for women,” says Alvaro Gomez, M.D., a Baptist Cardiac & Vascular Institute cardiologist.  “We need to treat hypertension in women more aggressively and at an early age.”

Who is at risk?

In the U.S., hypertension has been diagnosed in roughly 33 percent of adults, according to the Centers for Disease Control and Prevention (CDC). When you have hypertension or high blood pressure, you face a greater risk of a fatal heart attack or stroke, according to federal data.

But during the last several decades, the number of fatal cardiovascular cases has declined for men, but increased for women. What’s more, heart disease is the number one cause of death in women, according to the National Institutes of Health.

Why is hypertension more dangerous for women?

Several factors are at work, according to Dr. Gomez.  As a group, women do not seek out treatment for hypertension, he says.  And after the diagnosis, finding the right prescription medicine to treat hypertension in women can be more difficult, because some drugs present different side effects for women and men.

Even some preventive measures — such as taking a daily dose of baby aspirin to prevent a heart attack or stroke — can be less effective for women, compared to men, says Stratego Castanes, M.D., a South Miami Heart Center cardiologist. And finally, whether due to hormones or other physical traits, hypertension can be more toxic in women. Men and women with the same hypertension readings can face dramatically different outcomes.

What can women do?

• Know your numbers:  Track your blood pressure numbers, and don’t delay in seeking medical attention even if your numbers are only slightly elevated.
• Know your patterns:  Take time to measure your blood pressure at different times of the day to establish your personal scale. “Blood pressure varies throughout the day,” Dr. Castanes says. “Your blood pressure can be normal for most of the day, but if your pressure is elevated for even 20 percent of the day, you should consult with your doctor.”  Over the years, elevated blood pressure — even for a small portion of each day — could place you at greater risk for organ damage, stroke or heart disease, she says.
• Be persistent:  There are a variety of medicines that can treat hypertension. If one formula or brand gives you unpleasant side effects, work with your doctor to find the right prescription for your lifestyle and condition, Dr. Castanes says.

“Patients really have a lot of options with blood pressure medicine,” she says. “Keep an open line of communications with your doctor.”

That’s a message that Pat Chebab is happy to hear and to share with other women.

“Early detection, proper diagnosis and the right treatment can save or improve your life,” she says.

Tags: community health, heart disease, hypertension, Miami Cardiac & Vascular Institute, South Miami Hospital