Blood Pressure and Heart Health in Women

High blood pressure usually has no symptoms, so the only way to know your level is to have it measured. Heart disease in women can also show up differently from the classic crushing chest pain, with signs such as extreme tiredness, nausea, indigestion-like discomfort or pain in the back, neck or jaw.

Here is what to know about blood pressure numbers, warning signs in women, women-specific risk factors, and everyday habits that protect your heart.

Why blood pressure matters for women

WHO describes hypertension as one of the leading causes of heart and other health problems, and says around 44% of adults with it are unaware they have it. The CDC notes that high blood pressure often goes undiagnosed in women, even though it is a major risk factor for heart disease.

Because there are rarely warning signs, a regular check is more reliable than waiting to feel unwell.

What the numbers mean

Blood pressure is written as two numbers, for example 120/80. The top number is the pressure when the heart beats and the bottom is the pressure between beats. Guidelines vary by country, so ask your doctor which targets suit you.

• WHO and NHS: hypertension means 140/90 or higher in the clinic. WHO says the diagnosis needs readings on two different days, and the NHS gives 135/85 or higher for readings taken at home.
• CDC (United States): normal is below 120/80, elevated is 120 to 129 over below 80, and high is consistently 130/80 or above.
• Very high: WHO says 180/120 or higher is usually considered very high and needs prompt medical attention.

A single high reading, for example when you are anxious or have rushed to the clinic, does not confirm a diagnosis. Your doctor may ask for repeat or home readings.

Heart attack signs in women

The CDC lists these symptoms in women. Some women have only one or two, and some have none:

• Chest pain, pressure or discomfort
• Pain in the upper back, neck, jaw or throat
• Indigestion or heartburn, nausea or vomiting
• Extreme tiredness
• Dizziness and shortness of breath
• A fluttering feeling in the chest

The NHS also lists sweating, and pale, blue or grey skin, which may be easier to see on the palms in people with brown or black skin.

When to be cautious: Chest pain that does not go away, pain spreading to the arm, neck, jaw or back, or chest pain with sweating, nausea or breathlessness is an emergency. The NHS says not to drive yourself to the hospital. Get someone to take you, or arrange transport, and go straight to a hospital emergency service.

Risk factors, including those that are specific to women

The CDC lists high blood pressure, high LDL cholesterol, smoking, diabetes, excess weight, an unhealthy diet, physical inactivity, heavy alcohol use, stress and depression as common risk factors. It adds factors linked to women's health:

• Pregnancy complications: high blood pressure in pregnancy, gestational diabetes, preterm delivery. Women with high blood pressure in pregnancy have about twice the risk of heart disease later.
• PCOS: listed as a reproductive risk factor.
• Early menopause: menopause before age 40 raises risk, and risk generally rises after menopause because of hormone changes.
• Early first period: a first period before age 11.

If you have had preeclampsia or gestational diabetes, tell every doctor you see later in life. Our guides on preeclampsia warning signs and gestational diabetes care explain these conditions.

Everyday habits that protect your heart

• Move: at least 150 minutes of moderate activity a week (WHO and CDC), plus strength exercise on 2 or more days a week according to WHO.
• Cut salt: WHO advises under 2 grams of sodium a day. Pickles, papad, packed snacks and salted fish add up fast, so taste before adding more salt.
• Eat well: more vegetables, fruit and whole grains; less saturated and trans fat from deep-fried food.
• Keep a healthy weight and ask your doctor what that means for you.
• Avoid tobacco in any form.
• Limit alcohol: WHO says no more than one drink a day for women. Avoid it entirely in pregnancy, as the CDC advises.
• Manage stress and sleep in healthy ways, and talk to someone if you feel low.

The CDC also suggests asking your doctor about diabetes and cholesterol tests. For more daily habits see 10 healthy lifestyle habits every woman should follow.

Tip: When measuring at home, sit quietly for a few minutes with your back supported and your arm at heart level. Take the reading at about the same time each day and write it down to show your doctor.

When to see a doctor

• You have never had your blood pressure checked, or it has been several years. The NHS suggests adults over 40 get it checked at least every 5 years.
• You have frequent headaches or blurred vision, or chest pain that comes and goes.
• Your home readings are repeatedly above the targets your doctor gave you.
• You are pregnant and notice severe headache, vision changes or sudden swelling; see high-risk pregnancy care without delay.
• You have diabetes, kidney disease, PCOS or a family history of heart disease.

WHO notes that very high blood pressure can cause severe headache, chest pain, dizziness, difficulty breathing, vision changes and confusion, and that these need immediate care.

What to expect at the doctor

Expect a blood pressure check, questions about family history, diet, smoking, past pregnancies and your periods or menopause, and possibly blood tests for sugar and cholesterol. If your pressure is high, the doctor may ask you to monitor at home first. Treatment usually begins with lifestyle changes; your doctor may prescribe medicine if needed, and you should never stop or change it on your own.

Talk to a doctor

A simple blood pressure check takes minutes and can protect your heart for years. You can book an appointment or call +91 944 103 0587. This article is for general awareness and is not a substitute for a doctor's advice.