Hypertension And Stroke Risks Among Women

Women face unique health risks related to high blood pressure and stroke

High blood pressure and stroke adversely affect women in the U.S., especially women of color. With the convergence of the health observances National High Blood Pressure Education Month, National Stroke Awareness Month, and National Women’s Health Week (May 8-14), now is the perfect time to learn more about these diseases, their impact on women, health risks and causes among women.

What is high blood pressure?

Blood pressure measures the pressure of blood pushing against artery walls while active (systolic) and while inactive (diastolic). It is expressed as the systolic number over the diastolic number. 

The American Heart Association (AHA) defines high blood pressure — hypertension — as that force being consistently too high over time. The AHA identifies five stages of high blood pressure
•    Normal = systolic less than 120 AND diastolic less than 80
•    Elevated = systolic between 120 – 129 AND diastolic less than 80
•    Hypertension Stage 1 = systolic between 130 – 39 OR diastolic between 80 – 89
•    Hypertension Stage 2 = systolic 140 or higher OR diastolic 90 or higher
•    Hypertensive Crisis = systolic higher than 180 AND/OR diastolic higher than 120

According to the CDC, 44% of women have high blood pressure. Though it is most common among Black adults, White adults have the highest rates of control under medication and physician care.

Left untreated, hypertension can lead to many other chronic diseases and stroke.

What is stroke?

Stroke occurs when blood flow to the brain is blocked, starving the brain of vital nutrients and oxygen which leads to brain cell death within minutes. It is a medical emergency requiring immediate attention and recovery is dependent on quick treatment. 

More than 40% of women are at risk of stroke. While stroke kills more than twice as many women as breast cancer each year, it is the leading cause of death among Black women and the third-leading cause of death among Hispanic women.

High blood pressure and stroke impact on women

While women are slightly less likely than men to have hypertension or to suffer a stroke, they do carry some unique risk factors. Because women live longer, they endure hypertension impacts longer and have an increased stroke risk later in life. Menopause, birth control, and increased rates of depression among women increase high blood pressure risks.

Women who develop high blood pressure during pregnancy are not only likely to experience dangerous birth-related complications, but also hypertension which may appear later in life. Because Black women have a 60% increased risk of developing preeclampsia during pregnancy, the risk of post-pregnancy hypertension and other cardiovascular disease also increases.  

Black women also have higher stroke risks due to greater prevalence of obesity. Sickle Cell disease, common among Black women, increases stroke risk. Diabetes, which can be attributed to or worsened by high blood pressure, also contributes to higher risk of stroke. In fact, women with uncontrolled diabetes are more likely to die from stroke than men.

High blood pressure and diabetes increase the risk of stroke. Approximately 25% of Hispanic women have Stage 2 Hypertension and it is uncontrolled in nearly half of them. More than 10 of Hispanic women have diabetes, which is most common in those of Mexican and Puerto Rican descent. Obesity also is at approximately 50% among Hispanic women.

Though less likely to have increased risks such as obesity, tobacco use, and possessing an overall lower rate of hypertension, Asian-American women are least likely to have high blood pressure under control. Asian-Americans are 40% more likely to be diagnosed with diabetes than White persons, increasing stroke risk factors.

Early diagnosis, interventions lead to improved health outcomes

Both hypertension and stroke show improved outcomes with preventive and early treatments. Simply understanding the meaning of a blood pressure reading and having a reliable, at-home blood pressure monitor can make a positive difference in someone with a diagnosis and preventing hypertension in others.

Preventive treatments for hypertension require regular, ongoing monitoring and support. Making lifestyle changes — improving eating habits, adopting exercise, smoking cessation — can lower hypertension and stroke risks tremendously. However, they are also very difficult due to established habits, finances, and even geography.

Barriers to treatment and monitoring also include access to healthcare and societal/cultural influences. Even within ethnic and racial groups, there are vast risk and outcome differences. For example, American-born Black women are more likely to be diagnosed with preeclampsia in pregnancy than those who have immigrated to the U.S. Thus, intervention and control approaches need to take those aspects into consideration to be successful.

Leveraging data to establish successful protocols

Considering the many nuances of high blood pressure and stroke risk among women, developing a single set of interventions and protocols based solely on gender likely would not result in great outcomes for many patients.

Leveraging existing data and applying tools such as predictive analytics and machine learning can help develop focused processes and policies to guide ongoing interventions for improved outcomes. The RTI Health Advance team can assess data and activate proprietary data analysis tools to develop recommendations for targeted protocols and processes benefitting specific sub populations and their unique health needs.

Using stratified data minimizes the risk of generalized assumptions that might reduce success rates.

Connected care services key for positive health outcomes

Connected care — the convergence of electronic health records, telehealth, and personal health monitoring data — can help overcome these barriers. Because hypertension outcomes are best when taking a high-touch approach, connected care can benefit many patients, especially those without nearby care options.

Learn how our Population Health services can help providers and payers leverage data to improve women’s health.