IO – “Hypertension in women is unique because of hormonal changes that accompany each stage of her life cycle. From childhood, teen years, young adulthood, maturity, menopause, to old age, there are gender-specific changes that place women at a risk of hypertension and its complications,” said dr. Siska Suridanda Dany, Sp.JP, FIHA, in a webinar titled “Are There Changes in Hypertension Treatments during the Pandemic?” held last Friday (18/02/2022).
As a member of the Indonesian Society of Hypertension (“InaSH”) Consensus Guidelines Work Force, dr. Siska stated that hypertension is found in 10% of all pregnancies, and it is the second biggest contributory cause of death among pregnant mothers in developing countries. Treatment of hypertension and its complications during pregnancy must also consider the hormonal changes that are occurring in the mother, as well as other aspects of her physical condition. The use of hormone-adjusting drugs as contraceptive is also a gender-specific cause for increased blood pressure.
“Hypertension in relation to contraceptive pills is found in 2%-5% of women with initially normal blood pressure, while increase of blood pressure in women with hypertension occurs in 9%-16% of contraceptive pill users. Hypertension risk levels are correlated to the type and dosage of contraceptives used, smoking habits, extreme age of mothers (mothers who are 17 years old or younger, or who are 40 or older), a history of hypertension in the family, and obesity. If blood pressure remains high despite adjustment to the type and dosage of contraceptive pills, consumption must stop immediately,” dr. Siska said.
Hypertension during pregnancy can be divided into two groups: mothers who have a previous history of chronic hypertension, and those with no previous history of hypertension. Unlike chronic hypertension, high blood pressure triggered by pregnancy only occurs after the pregnancy is 20 weeks into the term, and will subside by itself gradually after the baby is born.
“Hypertension in pregnant women risk causing nerve damage, such as spasms, kidney failure, or blood coagulation issues. In babies, they risk having growth problems, premature birth, and death in the womb. Pregnant mothers must routinely perform control checkups of their pregnancy, sports, as well as adhere to a low-salt, low-fat diet,” said the heart specialist and blood vessel consultant from the National Cardiovascular Center, Harapan Kita Hospital, Jakarta.
Lowered Estrogen Levels
As a woman enters menopause, her body produces fewer and fewer estrogen hormones. Among other functions, this hormone is very important in relaxing the blood vessels and regulating blood pressure. Therefore, losing this hormone causes the woman’s blood vessels to become stiffer and to trigger difficulty in relaxing. She also becomes sensitivity towards salt, gains weight, has changes in fat metabolism, and suffers a narrowing of her blood vessels. This phase is highly critical for women, because of its high potential of hypertension and illness of the heart and blood vessels.
In 2018, InaSH issued its Consensus Concerning Hypertension in Women, which is a comprehensive documentation on the various aspects of hypertension throughout the lives of women, specifically in Indonesia. “We believe that this topic is always relevant for women’s health problems. We further hope that it serves as a reminder for women to always be aware and beware of hypertension and its complications, such as heart attacks, stroke, and kidney failure,” dr. Siska said.
At the same event, InaSH Chairman dr. Erwinanto, Sp.JP(K), FIHA, reported that the prevalence of hypertension in Indonesia, according to its 2018 survey, is about 34%. “This level did not change from the one in our 2007 survey. Ironically, our May Measurement Month survey records that only 37% of hypertension patients regularly drink their blood pressure control medicine, even though controlled blood pressure (lower than 140/90 mmHg) can help prevent Hypertension Mediated Organ Damage (HMOD), which is frequently a fatal condition. Another important step is for people to regularly and routinely perform blood pressure self-checks at home, which will remind them to take preventive measures.” (est)