Women's Hypertension: Misdiagnosed and Ignored as Stress or Menopause-Related Pain

 

Women's Hypertension: Misdiagnosed and Ignored as Stress or Menopause-Related Pain


High blood pressure (BP), sometimes referred to as hypertension, is a condition where the blood is pushing very hard against the vessels. High blood pressure has been found in roughly 69 per cent of people who experience their first heart attack, 77 per cent of people who experience their first stroke, and 74 per cent of those who experience heart failure, making it a significant risk factor for cardiovascular diseases (CVD).

One of the biggest gender-specific health risks is hypertension, which is frequently misdiagnosed in women as "stress" or "menopause-related" discomfort. Heart disorders and other serious health effects may result in death as a result of this.

According to TotalHealth, even though there may be no noticeable symptoms, some major manifestations of hypertension, particularly in women, include: Pre-eclampsia (high blood pressure during pregnancy), which is linked with a 4x increase in heart failure, hypertension, and a doubled risk of stroke; early natural menopause before the age of 40, which can also lead to cardiovascular diseases; rheumatoid arthritis; and lupus, which is characterised by a 3 per cent increase.

Additionally, if a woman has high blood pressure when she is pregnant, she is more likely to have it as she enters menopause. According to Professor Maas, director of the Radboud University Medical Center's Women's Cardiac Health Program, if blood pressure problems are not addressed in women's 40s or 50s, they will develop in their 70s when hypertension is more challenging to treat.

TotalHealth states that while Hormone Replacement Therapy (HRT) for women over 45 years of age reduces night sweats and hot flashes, it is advised to analyse cardiovascular risk factors prior to starting HRT due to the increased risk of blood clots associated with HRT. It is essential to think about care for transgender people when considering HRT. According to Professor Maas, "These women need hormone medication for the rest of their lives and the risk of blood clots increases over time."

The gendered character of high blood pressure

At the age of 50, normotensive women have a life expectancy that is roughly 5 years longer than that of hypertensive women. Post-menopausal women have a higher rate of sudden cardiac death than any other group of people, making up half of all coronary fatalities and 13% of all deaths overall.

According to a report from the Women's Health Initiative, hypertension has been found as a significant independent risk factor for sudden cardiac fatalities in a data set of more than 160,000 postmenopausal women (WHI).

Men seem to have slightly greater prevalence rates of hypertension than women do. According to data from the National Health and Nutrition Examination Survey (NHANES), more men than women had hypertension up until the age of 45. From 45 to 64 years of age, the percentage of people with this illness becomes comparable in both men and women.

Following this, women now have higher BP rates than males. However, it has been predicted that women will have hypertension more frequently than men in the near future. In other words, between the years 2000 and 2025, the prevalence of hypertension is predicted to rise by 13 per cent in women and by 9 per cent in males. The number below indicates that 483.5 million women had hypertension in 2000, and that number is expected to rise to 793.3 million by 2025.

Heart Illness in Women

Feminist activist Caroline Criado Perez wrote a book titled Invisible Women: Data Bias in a World Designed for Men in which she discusses a Leeds University study that claims women in the UK are 50% more likely to receive the wrong diagnosis for a heart attack.

"It's astonishing that we're still giving these women the wrong diagnoses," she says. Although we often refer to the symptoms of a heart attack in women as being unusual, this is not the case. And because cardiovascular research is the subject where the most work has been done on sex differences, we have known about the female symptoms [such as stomach discomfort, dyspnea, nausea, and exhaustion] for a long time.

In comparison to hypertensive men, increased arterial stiffness, atrial fibrillation, heart failure with preserved ejection fraction (HFpEF), and dementia at a longer age are associated with hypertension in women. Aortic aneurysms typically rupture when they are smaller in size because of the lesser diameter of their arterial system. Whether the threshold for normal BP should be lower in women than in males is still unclear. Only half of the hypertension patients receive the proper care, and more women than men are affected by this.

Why is more awareness necessary?

Positive results have come from the efforts as awareness of female hypertension and related issues rises. The percentage of women in the U.S. who were aware that cardiovascular disease (CVD) was the main cause of death nearly doubled between 1997 and 2012 (56 per cent vs. 30 per cent with a significance of p0.001). It is important to note that race has a crucial impact on the level of awareness among women. Specifically, discrepancies have been seen between women of colour and white women, with Black and Hispanic women in 2012 having awareness levels comparable to White women in 1997.

In India, these intersectionalities also have an impact on how women with hypertension are diagnosed and treated. Due to gender norms, the social assumption that women must suffer in quiet, and the reluctance to listen to women's health-related problems, hypertension in women is rarely treated seriously.

Women will become more aware of their symptoms and indicators as a result of a greater understanding of the gendered aspect of hypertension, and they will be better able to communicate this information to their doctors. Thusly provided complete medical histories can aid in the earlier diagnosis and prevention of heart failure and other related disorders.

This is not to argue that patients alone are solely responsible for this problem. In the end, listening to patients and improving communication in fields like cardiology, endocrinology, and gynaecology is crucial.

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