what is the relative risk for hypertension in women 50+ years versus women < 50 course hero

The rates of hypertension increased slowly with age for men, but for women a sudden increase was found at 48 years of age, the mean age of menopause. At 50 years of age or older, the rate for hypertension was 22.3% for men and 41.7% for women (chi 2 = 7.27, p = 0.007).

Full Answer

How to reduce BP after menopause?

Weight loss, in addition to dietary intervention such as the DASH diet, has been studied in women and shows incremental benefits on BP lowering and CV biomarkers. 34 Moreover, reducing alcohol consumption may lower BP in a dose-dependent manner above a threshold of two drinks per day. 35 A recent systematic review and meta-analysis of 36 trials, including 401 women, suggests a 1.2% decrease in the proportion of women with systolic BP >140 mmHg when alcohol intake is reduced. 35 The current guideline recommends no more than one standard alcohol drink per day for women. 4 The role for CV fitness in improving hemodynamics and long-term CV outcomes has been well established. Combined aerobic and resistance exercises reduce arterial stiffness and BP in postmenopausal women. 36

Is there evidence for differential effects of antihypertensive therapy based on gender?

There is currently no substantial evidence for differential effects of antihypertensive therapy based on sex or gender. 5,21,28 However, comorbidities in women may influence the choice of antihypertensive treatment. Diuretic therapy, via reduced urinary calcium excretion, may have a positive effect on the prevention of bone loss ...

Does estrogen cause hypertension?

Rates of hypertension increase after menopause when estrogen levels fall. 5 This suggests estrogen may have a vascular protective effect in premenopausal women. Estrogen plays a role in endothelial homeostasis through its action on vascular, cardiomyocyte and brain receptors. 6-7 Estrogen causes endothelial vasodilation via upregulation of the nitric oxide pathway and inhibition or down-regulation of sympathetic and renin-angiotensin system (RAS) activity, as well as endothelin production. 6-8 Estrogen reduces oxidative stress via lower reactive oxygen species generation and increased antioxidant production and also reduces inflammation via inhibition of pro-fibrotic genes and stimulation of neoangiogenesis.6 Therefore, lower estrogen levels after menopause may partially explain lower arterial compliance and increased risk of hypertension in older women. 9-10

Does estrogen affect blood pressure?

Despite estrogen's potential benefit on vascular function, the addition of exogenous estrogen therapy after menopause has neutral effects on blood pressure (BP). 5,11-13 Similarly, there is no impact of exogenous estrogen on CV outcomes. 14,15 In contrast, exogenous estrogen use with an oral contraceptive pill (OCP) in premenopausal women increases blood pressure. 8,11 Although RAS and sympathetic activation may be underlying mechanisms, whether this is due to the effects of estrogen, progesterone or a complex interaction between the two is not well understood. Studies on the effects of progesterone are limited, with short term follow-up and mostly observational design. 16-18 Nevertheless, data to date suggest no increased risk of hypertension or short-term cardiometabolic outcomes with progesterone-only contraceptive pills. 16-18 Pregnancy related vascular complications, such as preeclampsia and gestational hypertension, are also associated with an increased risk of post-partum hypertension and long-term CVD. 19 Younger women with estrogen imbalance and conditions such as premature ovarian insufficiency, polycystic ovarian disorder and infertility may have an increased risk of developing hypertension. 20 Therefore, the role of estrogen on vascular function and homeostasis is complex and not entirely understood.

How are young women protected from hypertension?

Young women are protected from developing hypertension, in part, by endogenous estrogen. As women age, they become more likely to develop hypertension and the associated CVD outcomes. Women also have unique forms of hypertension associated with pregnancy, menopause, and the use of OCP.

What is the prevalence of masked hypertension?

Worldwide, the prevalence of masked hypertension is 10%, with an increased prevalence in Asia. 22 Men with a history of diabetes mellitus seem particularly at risk. In the United States, the prevalence of masked hypertension diagnosed by ABPM in untreated women is half as that seen in men (7% versus 18%).

What is the definition of hypertension during pregnancy?

The American College of Obstetricians and Gynecologists has classified hypertension during pregnancy into four categories: preeclampsia/eclampsia, chronic hypertension of any cause, chronic hypertension with superimposed preeclampsia, and gestational hypertension. 48 Preeclampsia is the syndrome of new-onset hypertension and proteinuria or, in the absence of proteinuria, hypertension associated with target organ damage, including thrombocytopenia, impaired liver function (elevated blood levels of liver transaminases to twice the normal concentration), the new-onset of renal insufficiency (elevated serum creatinine without antecedent renal disease), pulmonary edema, or new-onset cerebral or visual disturbances. The HELLP syndrome is a severe and life-threatening form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count. Eclampsia is preeclampsia with seizures. Chronic hypertension in pregnancy is BP ≥140/90 mm Hg preceding the onset of pregnancy, or appearing before the 20th week of pregnancy, or lasting longer than 12 weeks postpartum. Chronic hypertension with superimposed preeclampsia is the development of preeclamptic/eclamptic symptoms in pregnant women with chronic hypertension. Gestational hypertension is elevated BP detected after the 20th week of pregnancy without features of preeclampsia.

What is white coat hypertension?

White-coat hypertension is defined as elevated in-office BP (≥140/90 mm Hg) and normal ABP (awake day-time ABPM <135/85 mm Hg) in individuals not receiving antihypertensive therapy . 21 Women, particularly older or pregnant women, are at increased risk for white-coat hypertension. 9 In the United States, a higher percentage of women (43%) than men (34%) have white-coat hypertension, assessed by ABPM. 8, 9 Worldwide, investigators from the international ARTEMIS project (Ambulatory Blood Pressure Registry: Telemonitoring of Hypertension and Cardiovascular Risk) diagnosed white-coat hypertension in 23% of 14 143 patients (49% women) evaluated in hypertension clinics across 5 continents with in-office BP readings and 24-hour ABPM. 22 White-coat hypertension was more common in elderly obese women and in Europe and Asia (25% versus 11% in other continents). The increased prevalence of white-coat hypertension in older women has been attributed to increased anxiety and metabolic syndrome in this population, in addition to hormonal changes. 23, 24 Furthermore, pathophysiological changes with aging, including increased arterial stiffness and diminished baroreceptor sensitivity, result in larger increases of BP in response to psychological stress. 21

What is masked hypertension?

Masked hypertension is defined as normal in-office BP and elevated ABPM (awake day-time ABPM >140/90 mm Hg). 29 Risk factors include male sex, older age, in-office prehypertension, and diabetes mellitus. Worldwide, the prevalence of masked hypertension is 10%, with an increased prevalence in Asia. 22 Men with a history of diabetes mellitus seem particularly at risk. In the United States, the prevalence of masked hypertension diagnosed by ABPM in untreated women is half as that seen in men (7% versus 18%). The prevalence of masked hypertension in women increases with body mass index and alcohol intake, perhaps contributing to the increased rate of cardiovascular outcomes in these women. 8

What is the leading cause of death in women?

Cardiovascular disease (CVD) is the leading cause of death in women in every major developed country and most emerging countries. 1, 2 Hypertension, the most common modifiable risk factor for CVD, is estimated to occur in 85.7 million adults in the United States (44.9 million women and 40.8 million men). 3 Elevated blood pressure (BP) >140/90 mm Hg is associated with a shorter life expectancy overall, shorter life expectancy free of CVD, and more years lived with CVD. 3 – 5 Hypertension is less common in women, compared with men, in those younger than 65 years of age, but is more common in elderly (65 years and older) women than men. In the United States, between 2011 and 2014, the prevalence of hypertension in women and men by age group was 8% versus 11% (20–34 years), 23% versus 23% (35–44 years), 33% versus 36% (45–54 years), 56% versus 58% (55–64 years), 66% versus 64% (65–74 years), and 81% versus 73% (≥75 years). 3

Can white coat hypertension be sustained?

Evidence that white-coat hypertension can become sustained hypertension over the long-term further calls into question its putative benign nature. 28 Further studies are clearly needed to assess the prognostic significance of white-coat hypertension in women, particularly elderly women, at high CVD risk.

What are the risk factors for hypertension?

To isolate the risk arising from hypertension, the researchers adjusted the figures to account for other risk factors, namely diabetes, smoking, body mass index, cholesterol levels, and physical activity levels.

How often should blood pressure be measured?

If women have other risk factors for heart disease, such as obesity, diabetes, autoimmune disorders, [or] pregnancy complications, or if they have parents with high blood pressure, their blood pressure should be measured every 1–2 years.”.

Can a woman with high blood pressure have angina in her 50s?

Women in their early 40s with mild hypertension, elevated blood pressure, may be twice as likely as those with normal blood pressure to have a heart attack or unstable angina in their 50s, a new study suggests.

Do men have hypertension in their 40s?

While men are more likely than women to have hypertension in their early 40s, damage to arteries appears to begin at lower blood pressures in women.

Does the current study record who was receiving antihypertensive treatments at the start of the study?

She noted that the current study recorded who was receiving antihypertensive treatments at the start of the study, but not during the follow-up.

Does high blood pressure affect women's hearts?

“The results add to emerging evidence indicating that high blood pressure has particularly unfavorable effects on women’s hearts,” says lead study author Dr. Ester Kringeland.

Who is Joanne Whitmore?

MNT asked Joanne Whitmore, a senior cardiac nurse at the British Heart Foundation, to sum up what individuals can do to minimize their risk of developing hypertension.

How much did the percentage of people with high blood pressure decrease in 1999?

In fact, the percentage of people with high blood pressure decreased from 47% in the 1999–2000 period to 42% in 2013–2014. However, the percentage rose again to 45% in 2017–2018. 7

How many people are aware of high blood pressure?

One study found that in 2017-2018, only 58% of adults under the age of 40 were aware they had high blood pressure. 7

What Do Blood Pressure Numbers Mean?

Blood pressure readings are composed of two numbers—for example, 120/80 mm Hg.

What is the normal blood pressure for adults?

According to the American Heart Association, normal blood pressure for adults (ages 20 and older) is less than 120/80 mm Hg. 2. On the other hand, hypertension is defined as having a systolic pressure of 130 mm Hg or higher, or a diastolic pressure of 80 mm Hg or higher, most of the time. 3.

How to measure blood pressure?

To measure blood pressure, a cuff attached to a monitor is placed on your arm. The cuff is then inflated with an air pump until its pressure stops blood flow from your brachial artery—the major artery found in your upper arm.

How to choose a blood pressure monitor?

When selecting a blood pressure monitor, consider the following: 1 Fit: To ensure a proper fit, measure around your upper arm and choose a monitor that comes with the correct size cuff. 2 Number of people: If more than one person will be using the monitor, make sure to choose one that fits everyone. 3 Features: Some blood pressure monitors offer extra tech features, like Bluetooth and app connectivity. If you don't think you'll benefit from these extras, go ahead and choose one that is efficient, easy to use, and more affordable. 4 Budget: High-quality blood pressure monitors vary dramatically in price, from around $25 to well over $100. Keep in mind that a good monitor is a great investment and that you will be using it daily for several years. 5 Other considerations: The AHA notes that when selecting a blood pressure monitor for a senior, pregnant person, or child, you should make sure it is validated for these conditions.

What was the average blood pressure in 2015?

In 2015, the average blood pressure worldwide was 127/79 mm Hg in men, and 122/77 mm Hg in women, according to a study analysis published in Lancet. 4