Almost one in two Americans has high blood pressure (also known as the “silent killer” because of its negative effects on the heart and blood vessels), but many people don’t know they have high blood pressure. In a study presented at the American College of Cardiology’s Annual Scientific Sessions (ACC.26), researchers report that high blood pressure-related heart disease is an increasing proportion of deaths among women ages 25 to 44, increasing from 1.1 to 4.8 deaths per 100,000 women in this age group between 1999 and 2023.
High blood pressure damages the heart and is an indicator of heart disease risk. Taking active steps to control blood pressure can help prevent life-threatening cardiac events, but the risks of uncontrolled hypertension may be overlooked among young women and their clinicians. Previous studies have primarily investigated the risk of hypertensive heart disease in men and postmenopausal women. This study is one of the first to focus on young women.
Increased mortality among young women with hypertensive heart disease reflects underestimation of cardiovascular risk, delayed diagnosis, and missed opportunities for early intervention. This study highlights the urgent need for specific prevention strategies. ”
Alexandra Millhuff, DO, resident at the University of New Mexico and lead author of the study
Lifestyle modifications such as quitting smoking, eating a heart-healthy diet, and increasing physical activity are the first steps in managing high blood pressure, and antihypertensive medications can be added if needed. If high blood pressure is left uncontrolled for a long time, it can weaken the heart muscle and lead to heart failure, coronary artery disease, heart attack, and stroke. New ACC/AHA guidelines on prevention, detection, evaluation, and management of hypertension in adults emphasize the importance of early treatment to keep blood pressure below 130/80 mmHg.
Researchers analyzed death certificate data for U.S. women who died between the ages of 25 and 44 to assess mortality rates from hypertensive heart disease during the study period. Results in 1999 showed that 1.1 in 100,000 deaths among young women were due to hypertensive heart disease. By 2023, the rate had more than quadrupled, accounting for 4.8 deaths per 100,000 people in this population. More than 29,000 women died from hypertensive heart disease-related deaths during the study period.
The study also revealed significant differences based on factors such as race and geography. Non-Hispanic black women had the highest hypertension-related mortality rate during the study period, at 8.6 per 100,000, compared with 2.3 per 100,000 for non-Hispanic white Americans. Across U.S. regions, women in the South had the highest hypertension-related death rate at 3.8 per 100,000, compared with 2.8 in the Midwest, 2.2 in the Northeast, and 1.9 in the West. No differences were found between women living in urban and rural areas.
Many studies have shown that women are less likely to be prescribed blood pressure medications than men, and the researchers said heart disease treatment and awareness efforts often focus on men and postmenopausal women, with less attention to assessing cardiovascular risk in younger women.
“We need to be more aggressive in testing for high blood pressure in this population, including reducing risk factors and possibly using antihypertensive medications,” Milhuff said. “While high blood pressure is more common in older people, young people need to be just as careful.”
Researchers said women face particular cardiovascular risks related to hormonal and other physiological changes that occur during pregnancy and perimenopause. They emphasized the importance of controlling blood pressure and addressing other risk factors to ensure women are in optimal health before reaching menopause or considering pregnancy.
Because most young women do not see a cardiologist regularly, the researchers emphasized the role of primary care and female health care providers in screening and managing hypertension in this patient population. She said women can take an active role by asking their doctors about their cardiovascular risks and opportunities to improve their health care.
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American College of Cardiology
