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Experts urge women to get health check to avoid higher risk of stroke



Experts from the European Society of Cardiology (ESC) have urged women to get a simple health check-up in order to help prevent their risk of stroke. 

The experts say that all women should know their blood pressure. ESC spokesperson Professor Angela Maas, says: “Cardiovascular disease is the leading cause of death in women.

“The risk for cardiovascular disease increases at a lower blood pressure level in women compared to men. My message to all women is to take your blood pressure seriously, know your values and convince your doctor that if it is too high then you need treatment. Don’t underestimate the long-term effects of high blood pressure.

“One of the most important consequences of hypertension in women is a type of heart failure in which the heart muscle is stiff.

“There are few treatments for that condition, so if you want to avoid symptoms such as shortness of breath, fatigue and fluid retention when you are over 70, you have to start treating high blood pressure in middle age. If you wait 20 years, it is too late.”

Research has shown that around one in three women worldwide have hypertension globally and also that raised blood pressure has been named the most important risk factor for death in women across the world.

Professor Maas, says: “Despite its importance, we know that hypertension is more often underestimated and not, or insufficiently, treated in women compared to men.

“One of the reasons may be that below the age of 50, hypertension is more prevalent in men. This reverses in the years after menopause so that after the age of 65, hypertension is more common in women than men.”

The experts believe there is a misconception that high blood pressure does not cause symptoms and that the symptoms are actually more pronounced in women but may be mistaken for menopause, anxiety or stress.

Professor Maas, says: “When we treat hypertension, many symptoms erroneously attributed to menopause disappear.

“Night sweats can be caused by high blood pressure, for example, so women with menopausal symptoms should have their blood pressure checked and treated if needed.”

Hypertension is more harmful for women in midlife than men of the same age, it is also a stronger risk factor for myocardial infarction, cognitive decline and dementia. The likelihood of stroke increases at a lower blood pressure level in women than men.

Professor Maas, says: “Hypertension is currently defined as a systolic blood pressure of at least 140 mmHg and/or diastolic blood pressure of 90 mmHg or higher. But discussions are underway about whether normal blood pressure values should be lower in women compared to men. More research is needed before there is any change in treatment guidelines but I expect that within five years the threshold for normal blood pressure will be lower in women than men.”

Researchers say that certain life events predispose women to developing hypertension such as having migraines from their teenage years, having two or more miscarriages, hypertension during pregnancy (which affects around one in seven pregnant women) and preeclampsia (a more severe form of hypertension during pregnancy).

Professor Maas, says: “Women have more of those specific life events than men. 

“Physicians can use these clues to identify middle aged women at higher risk of hypertension and to signal that blood pressure monitoring needs to be taken more seriously.”

On knowing your blood pressure, Professor Maas, says: “I always advise my female patients to share a blood pressure device with their sisters, neighbours or friends and measure it themselves. When we asked women with preeclampsia to check their blood pressure at home, approximately one in four had hypertension that would have been missed with usual care.”

When should you start measuring blood pressure and how often?

It is recommended to start yearly monitoring from 40-years-old if you have a history of hypertension in your family or if you had hypertension during pregnancy. Women with preeclampsia should check their blood pressure from that pregnancy onwards at least twice a year.

Women with no issues during pregnancy and no family history should start yearly measurements from 50-years-old when they enter the menopause.

How high is too high?

A diagnosis of hypertension does not come from one measurement. Women under the age of 80 should see their doctor for further investigation if their systolic blood pressure is 130 mmHg or higher, as for those over 80 a value of 50 mmHg should trigger a visit to the doctor.

Professor Maas, says: “A healthy lifestyle is also important to prevent or treat high blood pressure. That means regular exercise, a nutritious diet, reducing salt intake, smoking cessation, losing excess weight and limiting alcohol consumption.”