If left uncontrolled, high blood pressure is an important risk factor for cardiovascular disease and stroke. Women must be particularly attentive to this risk, especially at certain periods of their hormonal life: when they are on oral contraceptives, during pregnancy and at menopause.
Contraception: a first opportunity for screening
Taking a first hormonal contraceptive (pills, implants, patches, vaginal rings) containing synthetic estrogens is an opportunity to perform an initial screening for high blood pressure (HTA). Indeed, among women of childbearing age, 4% of those under 34 and 8% of those aged 35-44 are hypertensive.
“Taking a contraceptive containing synthetic estrogens can be accompanied by a most often moderate rise in blood pressure“ emphasizes Professor Claire Mounier-Vehier, Cardiologist and Head of the Vascular Medicine and Arterial Hypertension Department at the Institut Coeur Lung of the University Hospital of Lille.
However, as the French Committee for the fight against arterial hypertension points out, “the prescription of oral contraception remains possible in a well-controlled woman, in particular with micro-progestins, because it is mainly oestrogens that cause hypertension”.
Pregnancy: a common cause of hypertension
It happens that a pregnant woman, especially during her first pregnancy, develops specific hypertension (HTA). “This concerns 10 to 15% of pregnant women” insists Professor Mounier-Vehier.
Screening for hypertension must therefore be done every month from the first trimester of pregnancy, even if this hypertension most often appears from the 2nd trimester.
It must be managed in a coordinated way with the obstetrician, the cardiologist and the attending physician to avoid maternal and fetal complications. “This also makes it possible to identify women who are more at risk of developing hypertension or a cardio-cerebrovascular accident at maturity. The challenge therefore consists in teaching them certain rules of hygiene of life and in following them regularly throughout their lives. throughout their lives” declares the French Federation of Cardiology.
Menopause: an increased risk
At menopause, natural estrogen gradually decreases, thickening the walls of the arteries which become more rigid. At the same time, women often gain weight, favoring the appearance of the metabolic syndrome (abdominal obesity). The prevalence of arterial hypertension in women then increases significantly, to affect one in two women after 65 years of age.
This then multiplies the risk of having a stroke, a heart attack or suffering from heart failure. “This is why we advise women to carry out recurrent screenings from the menopause and to have their blood pressure taken by the doctor at each visit” recommends the Federation of Cardiology. “In case of high figures above 140/90 mm Hg, a self-measurement over three days or an ambulatory measurement over 24 hours should be proposed to confirm or not the diagnosis of arterial hypertension and to decide on the best therapeutic management.”
Read also :
- 5 ways to normalize your blood pressure naturally
- Hypertension: the first treatment is not necessarily the right one
- Infographic: what you need to know about blood pressure
