According to a new consensus document from European cardiologists, gynecologists, and endocrinologists, doctors should make much stronger efforts to detect high blood pressure in middle-aged women.
The study authors said that high blood pressure in women is often written off as either stress or menopausal symptoms, both by their doctors and by the women themselves.
When the diagnosis is overlooked, however, it can cause women to delay treatment, putting them at greater risk for conditions like heart failure and stroke.
Better recognition of high blood pressure is an important step to reducing women’s cardiovascular risk.
Dr. Angela H.E.M. Maas, who was the lead author of the document, said that high blood pressure is taken more seriously in men and less well treated in women.
She said this is because we consider elevated blood pressure in women often as “stress,” and in men as “hypertension.”
“This is partly because of bias by doctors, but also by women themselves,” Maas said. “Women often explain an elevated blood pressure as stress-related and are not always open to the hypertension diagnosis and treatment.”
Maas said it can often take more time to convince women and to start and continue medical treatment.
“The timing of onset of hypertension is often at the start of menopause and this leads to overlapping symptoms that are not always properly adjudicated,” she said.
In the past, women were considered less likely than men to have heart disease, according to Dr. Maan Malahfji, a cardiologist with Houston Methodist DeBakey Cardiology Associates, who was not associated with the consensus report.
This may have resulted in doctors being less aggressive in investigating its symptoms and controlling them.
Now there’s growing recognition that women are at just as much risk as men after going through menopause, and there may even be more complications.
“Elevated blood pressure can be manifested in different ways between men and women, but is very often without any symptoms, so screening is vital,” Malahfji said.
Maas said one thing that leads to confusion in diagnosing high blood pressure in middle-aged women is the fact that its onset often coincides with menopause.
When symptoms occur that overlap with menopausal symptoms, people may simply dismiss them as being menopause.
“Think of hot flashes, sleeping disorders, chest pain, pain between the shoulder blades, irregular heartbeats, headaches, symptoms of fluid retention, dyspnea (shortness of breath), etc.,” she said.
These are all symptoms that overlap with hypertension symptoms.
In addition, Malahfji pointed to symptoms like headaches, ringing in the ears, and changes in concentration as potential high blood pressure symptoms that might be attributed to menopause.