Hypertension in Women Across the Life Cycle: Unique Aspects and Challenges

TL;DR

This paper reviews how hypertension affects women differently at various life stages and emphasizes the need for sex-specific approaches to improve cardiovascular outcomes.

Contribution

The paper provides a life-course review of hypertension in women, integrating recent guidelines and highlighting stage-specific clinical strategies.

Findings

Women face unique hypertension risk factors across life stages, including pregnancy and menopause.

A sex-informed approach to hypertension management is essential for reducing cardiovascular risk in women.

Addressing evidence gaps and implementing sex-specific care can improve equitable cardiovascular outcomes.

Abstract

Hypertension is a major driver of cardiovascular morbidity and mortality in women, with risk trajectories that evolve across the female life course. From reproductive years through menopause, sex-specific biological, hormonal, and social factors contribute to unique patterns of blood pressure risk and cardiovascular vulnerability.

To provide a life-course review of hypertension in adult women and highlight stage-specific risk factors, clinical considerations, and opportunities for prevention and management.

Women experience distinct exposures that influence hypertension risk, including hypertensive disorders of pregnancy, adverse pregnancy outcomes, psychosocial stressors, cardiometabolic changes, and the transition through menopause. This review integrates key recommendations from the 2025 American College of Cardiology/American Heart Association High Blood Pressure Guideline and emphasizes practical, stage-specific approaches to screening, risk stratification, and treatment tailored to women.

A life-stage–specific, sex-informed approach to hypertension is essential to improve early identification, optimize treatment, and reduce long-term cardiovascular risk in women. Addressing persistent evidence gaps and prioritizing implementation of sex-specific care strategies will be critical to advancing equitable cardiovascular outcomes.

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