Reducing the Risk of Heart Disease in Middle-aged Women

A significant number of middle-aged women worldwide could reduce their risk of developing cardiovascular disease and its complications by lowering their blood pressure, according to research published in Hypertension: Journal of the American Heart Association.

In the study, researchers found that high systolic blood pressure is a powerful risk factor for cardiovascular complications in middle-aged and older women all over the world. The proportion of potentially preventable and reversible heart disease is almost 36% in women compared to 24% in men, as measured by 24-hour systolic blood pressure monitoring.

Investigators in 11 countries, working on behalf of the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO), followed 9,357 adults (average age 53; 47 percent women) throughout Europe, Asia and South America for more than 11 years. Participants were analyzed for absolute and relative risks of cardiovascular disease associated with systolic blood pressure.

Three major risk factors account for 85% of the modifiable risk for heart disease in women and men: high systolic blood pressure, high cholesterol, and smoking.

“I was surprised by the study findings that highlight the missed opportunities for prevention of heart disease in older women,” said Jan A. Staessen, MD, PhD, director of the Studies Coordinating Center in the Division of Cardiovascular Rehabilitation at the University of Leuven in Belgium. “We found that a 15 mm Hg increase in systolic blood pressure increased the risk of cardiovascular disease by 56% in women compared to 32% in men.”

Researchers estimated the occurrences of cardiovascular disease in women and men that are potentially preventable by lowering blood pressure. The absolute and relative risks associated with high blood pressure were assessed using both ambulatory 24-hour blood pressure monitoring and conventional blood pressure measurements in the doctor’s office.

“It is recognized that women live longer than men, but that older women usually report lower quality of life than men. By lowering systolic pressure by 15 mm Hg in hypertensive women, there would be an increased benefit in quality of life by the prevention of cardiovascular disease in about 40% in women compared to 20% in men,” Staessen said in a press release.

He recommends that women and physicians become more aggressive in diagnosing and treating high systolic blood pressure.

Researchers are enlarging the database to include other countries and ethnicities. They are developing risk charts based on ambulatory blood pressure recordings to be used by physicians in day-to-day clinical practice.