When it comes to health, gender plays a role in how certain conditions or diseases affect us. Doctors don’t always know why one sex may be more prone to a disease than another, but the answers likely lie within our genetic makeup, anatomy and hormones. Brandie Williams, M.D., a cardiologist on the medical staff at Texas Health Stephenville, says that regulating blood pressure is different depending not only on the sex of the patient but also on age, habits and lifestyle factors. We wanted to know more, and asked Williams for her insights and advice.
First off, is one sex more susceptible to high blood pressure or related diseases? Williams says that men generally are at a greater risk for cardiovascular and renal disease, with hypertension — or high blood pressure — the leading risk factor for cardiovascular disease. Why is that? Call it stubbornness or fear, but men are statistically less likely to see a doctor regularly than women. That’s why men are at great risk. After all, if you’re not seeing your physician, you probably aren’t aware of health issues like hypertension, which are easily diagnosed and often treatable.
Conversely, women tend to see their primary care physicians more regularly, so they’re generally more aware of high blood pressure. According to Williams, “Women have higher awareness of all health issues, blood pressure included, because they’re likely to start seeing a health care provider at a younger age. For instance, women seek the primary care of an OB/GYN for birth control and gynecological services. During the doctor visits, their blood pressures are screened more frequently.”
Habits aside, the actual data shows hypertension rates in women and men are similar — averaging 30 to 40 percent in African Americans and 20 percent in Caucasian adults but rising with age. For example, hypertension affects 80 to 90 percent of women of all races over the age of 70, because menopause causes women’s blood pressure to rise to levels above those of males the same age. The silver lining: because women seek a physician’s care more regularly, they’re much more likely to be aware of that spike in blood pressure and get it treated.
So we know that menopause has an effect on women’s blood pressure. Let’s delve into hormones and the role they play a bit more.
We’ve established that post-menopausal women have higher blood pressure rates than men of the same age. But why is that? Williams says the ‘mechanisms’ responsible for gender differences are not completely understood, but that testosterone could be playing a role in causing hypertension. As an example, she cites women with polycystic ovary syndrome — where too much testosterone is produced in the ovaries — typically have elevated blood pressure and also are more likely to become obese due to the condition.
Considering anatomy and hormonal differences in the sexes, how does regulating high blood pressure differ for both genders? Perhaps surprising for some, Williams says there isn’t a difference in drug treatment and drug therapy based on gender. The goal is the same for both — to reduce blood pressure, the major determinant of cardiovascular risk in both younger and older patients. She adds that regardless of gender, we all benefit from lifestyle modifications like weight loss, getting plenty of exercise and eating a low-salt diet.
Most people simply consume more salt than they need, often without knowing it. The American Heart Association says the average American eats about 3,400 milligrams of salt a day — but recommends no more than 2,300 milligrams a day. Limiting daily salt intake even further, — to less than 1,500 milligrams is ideal for individuals with high blood pressure.
In addition, alcohol should be consumed in moderation, and that’s where gender is a factor. For men, that’s no more than two drinks per day. And for women, no more than one drink a day is advised to achieve a healthy blood pressure range. Williams reminds us that one drink is no more than one 12-ounce beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits. Reducing stress and quitting smoking are also important lifestyle choices that help lower blood pressure and the risk of cardiovascular disease in both sexes.
Speaking of weight loss, there’s real proof that losing weight can have a dramatic effect on blood pressure. In fact, blood pressure generally is reduced anywhere from 0.5-2 mmHg (millimeters of mercury are used to measure blood pressure) for every 1 kilogram or 2.2 pounds of weight lost.
Nearly half of Americans have high blood pressure, a key contributor to cardiovascular disease. Williams says each of us should know our blood pressure numbers. A simple blood pressure monitor available at most pharmacies is a great way to keep track of blood pressure between doctor visits. Seeing a primary care physician or cardiologist and getting treated is important. Why? Because most of the time, there are no symptoms associated with high blood pressure, which can go undetected for years.
The Heart & Vascular Services team at Texas Health Resources is trained to diagnose patients and begin treatment for hypertension, if needed. Your physician will determine the blood pressure goal for you, and the lifestyle modifications needed to achieve your goal.