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Hypertension in women

Eduardo Pimenta1

  • 1Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders, University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia. e.pimenta@uq.edu.au

Insights

Hypertension increases cardiovascular risk, particularly in women. Combined oral contraceptives can elevate blood pressure and CV risk, but these effects reverse upon discontinuation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Women's Health

Background:

  • Hypertension is a significant, modifiable risk factor for cardiovascular (CV) morbidity and mortality, prevalent in both sexes.
  • The prevalence of hypertension is projected to rise more rapidly in women than men.
  • Cardiovascular disease is the leading cause of death in women, surpassing cancer incidence.

Purpose of the Study:

  • To review the impact of hormonal therapies on blood pressure (BP) and cardiovascular risk in women.
  • To discuss the role of combined oral contraceptives (COCs) and hormone replacement therapy (HRT) in hypertensive women.
  • To highlight the importance of antihypertensive treatment benefits in women, comparable to men.

Main Methods:

  • Literature review of studies concerning hypertension, cardiovascular disease, and hormonal therapies in women.
  • Analysis of the effects of combined oral contraceptives (COCs) and hormone replacement therapy (HRT) on blood pressure.
  • Examination of cardiovascular risk associated with hormonal contraceptives and antihypertensive treatment efficacy in women.

Main Results:

  • Combined oral contraceptives (COCs) can induce hypertension and increase CV risk in a subset of women.
  • COC-induced increases in CV risk and blood pressure (BP) normalize within 3 months of discontinuation.
  • Antihypertensive treatment offers comparable benefits for women and men.

Conclusions:

  • Women with established hypertension may benefit from COCs and HRT containing drospirenone.
  • Discontinuation of COCs leads to the reversal of associated CV risk and BP elevations.
  • Effective management of hypertension is crucial for reducing cardiovascular mortality in women.

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