High blood pressure and what women can do about it


January 11, 1994|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

Women are encouraged to get mammograms and Pap smears every other year or so, but doctors should also encourage their patients to get their blood pressure checked -- especially older women.

High blood pressure, although prevalent throughout the population, is much more common in women than in men once they reach the age of 60.

To find out why this is so and what women can do to keep their blood pressure at a healthy level, I turned to Dr. Paul Whelton at the Johns Hopkins School of Hygiene and Public Health.

Q: How prevalent are high blood pressure problems?

A: In western cultures especially, high blood pressure is a very common problem for the whole adult population. The older we get, the higher our blood pressure seems to get. Therefore, doctors consider an entire range of blood pressure readings as normal depending on the age of the person.

A level that might be too high for a 25-year-old may be an acceptable level for a 65-year-old. Doctors who treat women with high blood pressure try to help them avoid the long-term effects of heart disease and stroke that are related to high blood pressure.

Q: How does a woman know if she has high blood pressure problems?

A: High blood pressure, or hypertension, is called the silent killer because it is unusual for a woman to have symptoms except with very advanced disease. That is why it is important for women to have their blood pressure checked regularly -- at least once every one to two years even if a woman is in good health.

African-American women must take particular care to have these checkups, since they have a higher risk of hypertension than white women.

The important thing to remember is a woman must be screened regularly so if she needs treatment, she can get it. Treatment for hypertension such as dietary changes or medications have been known to reduce the risk of heart disease and stroke.

There are many myths associated with high blood pressure and women should be careful not to put faith in them. For instance, many people believe that women are protected from the kind of high blood pressure problems that men have because of their hormone levels, but that is simply not true.

It is also untrue that headaches are usually a symptom of high blood pressure.

Q: What specifically can a woman do to make sure she stays within the "normal" range?

A: Women must take the following preventive steps to keep their blood pressure at a healthy level, no matter what their age.

* First, keep your weight down. Excess weight accounts for 30 percent of all the hypertension in the United States.

* Second, stay physically active. Sedentary lifestyles cause high blood pressure. A woman doesn't have to run to the gym every day and do an extensive workout, but she should stay active as part of her normal life.

Most doctors recommend that women find an activity they truly enjoy, such as walking, cycling or swimming, and then make time for it in their schedules at least four times a week.

* Third, limit salt. Begin by eliminating salt from your cooking and from the table. But that is only a beginning. Almost all processed foods in the United States are high in sodium, and we are a country dependent on processed foods.

Sixty percent of every food dollar in the United States is spent in restaurants, especially fast-food outlets. As people shop, they should also try to become more familiar with the sodium content of the foods they buy. Even small reductions make a difference in blood pressure levels.

* Finally, limit your intake of alcohol, which is responsible for 5 percent to 10 percent of all hypertension in the United States.

L Q: Is there a link between genetics and high blood pressure?

A: In almost all diseases there is a link between nature and nurture. With high blood pressure, while there are important genetic factors, they are not sufficient to cause high blood pressure. In other words, heredity alone will not cause high blood pressure.

If, however, a woman has had a family history of hypertension and then overeats, uses excessive salt, drinks heavily and leads a sedentary life, she will clearly be prone to these problems.

Repeated checkups by your health care provider can identify hypertension in its earliest stages. Treatments started when high blood pressure is first detected can greatly reduce the risk of heart disease, stroke and kidney disease that are the serious consequences of this disease.

The good news is that no one really has to have high blood pressure problems.

Dr. Genevieve Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is a founding director of the school's Institute for Women's Health Research and Policy.

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