Why hypertension symptoms in women are often mistaken for menopause

Why hypertension symptoms in women are often mistaken for menopause


The European Society of Cardiology (ESC) have published a document today in the European Heart Journal with medical experts revealing that women who experience complications during pregnancy and early menopause have an increased risk of heart disease. 

According to the research, up to 50 percent of women develop high blood pressure before the age of 60 but the symptoms, which include hot flushes and palpitations, are often linked to menopause.

A large group of cardiologists, gynaecologists and endocrinologists have included recommendations in the document on how to help middle-aged women prevent later heart problems. 

“Physicians should intensify the detection of hypertension in middle-aged women,” the document stated. 

Professor Angela Maas, director of the Women’s Cardiac Health Programme in the Netherlands and author of the study, said that when high blood pressure is presented in men, it is called “hypertension…but in women it is often mistakenly labelled as ‘stress’ or ‘menopausal symptoms’.”

“We know that blood pressure is treated less well in women compared to men, putting them at risk for atrial fibrillation, heart failure and stroke – which could have been avoided,” she said. 

“A woman’s life provides clues that you need to start early with prevention,” Professor Maas continued. “We have to assess female patients differently to men, and not just ask about high cholesterol. This will enable us to classify middle-aged women as high-risk or lower risk for cardiovascular disease.”

The report found that women who have an early natural menopause before the age of 40 are more likely to develop cardiovascular disease and that autoimmune inflammatory conditions such as rheumatoid arthritis and lupus are more common in women compared to men. They also reported an increase likelihood of cardiovascular risk around the time of menopause.

“There are several phases of life when we can identify subgroups of high-risk women,” Professor Maas said. “High blood pressure during pregnancy is a warning sign that hypertension may develop when a woman enters menopause and it is associated with dementia many decades later. If blood pressure is not addressed when women are in their 40s or 50s, they will have problems in their 70s when hypertension is more difficult to treat.”

The document offers guidance from medical experts on how to manage a healthy heart during menopause, after pregnancy complications, and during other conditions including breast cancer and polycystic ovarian syndrome (PCOS), which affects 8–13 percent of reproductive age women in Australia, with around 21 percent of Indigenous women affected.

Experts identified the importance of a healthy lifestyle and diet, especially during the menopausal years. For transgender women, the report advises they “should always be encouraged to reduce modifiable lifestyle risks” while disclosing that “the psychosocial benefits of hormone therapy with an improved body image may result in healthier lifestyle choices”.

“These women need hormone therapy for the rest of their lives and the risk of blood clots increases over time,” Professor Maas said.

“Women can help their doctors prevent heart problems and make earlier diagnoses by mentioning issues like complicated pregnancies and early menopause and monitoring their own blood pressure.”

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