Hypertension in Premenopausal and Postmenopausal Women

Abstract

To examine available clinical data on the differences between premenopausal and postmenopausal women with hypertension (HTN). Clinical conditions related to HTN and reproductive status differ in younger women compared with older women. Due to recent changes in the definition of HTN, the prevalence of HTN has increased significantly in all women. Rising rates of obesity among women of all ages increase the risk for HTN. Among younger women, long-term vascular consequences of preeclampsia, the under-reported prevalence of fibromuscular dysplasia, and widespread use of oral contraceptive pills in women with contraindications confer unique risks for HTN-related cardiovascular risk. For older women, insights on vascular aging and hormonal changes with menopause are shown to be gender-specific causal factors for HTN. Assessment of risk factors unique to premenopausal and postmenopausal women can facilitate the management of HTN and improve long-term outcomes. Further studies in women are needed to accurately stratify women risk based on these risk factors.