Phases in woman’s life when she is most prone to hypertension

Hypertension is defined as a condition in which the blood vessels have persistently raised pressure, increasing the pumping function of the heart and leading to hardening of the vessels.

“There are two types of hypertension; primary and secondary. Primary has no identifiable cause and tends to affect most adults and develops gradually over many years. Secondary hypertension is caused by an underlying condition and appears suddenly,” explains Bernard Gitura, a cardiologist at Upper Hill Cardiovascular Centre.

Hypertension and phases of life

Did you know that approximately one in every two Kenyan adults has prehypertension?  This is according to a recent study by scientists from the University of Nairobi.

Prehypertension is when blood pressure levels are above normal readings. It is a warning sign that you may develop high blood pressure in the future.

While hypertension can affect women in almost all phases of their life cycle, women go through dynamic changes across their life cycles-- puberty, motherhood, menopause and aging-- which on their own affect blood pressure.

1.    Teenage and young adult women

Published research indicates that adult hypertension has its origins in childhood and teenage years.

This raises the concern that elevated blood pressure in young women can contribute to early progression of heart diseases such as the accumulation of fats and cholesterol in blood vessels (premature atherosclerosis).

Possible risk factors for hypertension in children include:

Scientific evidence shows that obesity alone contributes to primary hypertension in adolescents.

“The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through the blood vessels increases, so does the pressure on your artery walls,” explains Dr Gitura.

2. Pregnancy-induced hypertension (PIH)

It is estimated that 9.1 per cent of maternal deaths in Africa are due to hypertensive disorders in pregnancy. WHO has documented PIH as the second-most cause of still births and early neonatal deaths in developing countries.

Worldwide, it is the third-leading cause of maternal death after hemorrhage and sepsis. Pregnancy-induced hypertension is specific to pregnant women when there is hypertension at or after 20 weeks’ of pregnancy.

Its diagnosis is when a woman’s blood pressure is above 140/90mmHG before week 20 of gestation or high blood pressure above 12 weeks after birth (postpartum).

3. After childbirth/lactation phase

Scientific research has widely documented the benefits of long-term breastfeeding. Women who breastfeed for a longer period have significantly lower risk of having high blood pressure compared to women who never breastfeed after child birth.

Lack of or premature discontinuation of breastfeeding places a woman at an elevated risk of metabolic syndrome and cardiovascular disease.

Also, the oxytocin hormone released during breastfeeding may reduce stress levels and subsequently, chances of development of hypertension.

4. Reproductive years with use of hormonal contraceptives

Combined hormonal contraceptives -- containing both estrogen and progesterone -- have been associated with a small yet significant effect on blood pressure.

This predisposition makes such contraceptives not suitable for women with pre-existing or at an elevated risk of hypertension.

5. Menopause

Most of us think of hot flushes and mood changes when we picture menopause. It is unlikely that hypertension and heart disease come to mind.

Well, they should. Generally, blood pressure increases after menopause. Some scientists blame the shift in hormone levels.

In response to the drop in levels of estrogen, your blood vessels become less elastic, causing an elevated blood pressure and strain of the heart muscles.

Monitoring of blood pressure during menopause could avert serious effects of unchecked blood pressure.

6. Hypertension in elderly women

Epidemiological studies suggest that the prevalence of hypertension in women exceeds that in men beginning about the age of 60.

“The risk of hypertension increases as you age. Until about age 64, it is more common in men. Women are more likely to develop increased blood pressure after age 65,” says Dr Gitura. Elderly women have additionally more severe hypertension and lower blood pressure control compared to middle aged and younger women. Aging is clearly a significant factor in the development of hypertension.