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The Hidden Risks: Unique Causes of High Blood Pressure in Women

Medically Approved by Dr. Edward Salko

Table of Contents

High blood pressure knows no gender or sex. Anyone can develop high blood pressure (hypertension), especially as a result of an unhealthy lifestyle. However, women are known to have added risk factors triggered by hormonal changes. 

Pregnancy, menopause, oral contraceptive usage, and reproductive issues contribute to a woman’s susceptibility to high blood pressure. These are on top of the common triggers for hypertension, like poor diet, inactivity, stress, unhealthy habits, and existing medical conditions.

Learn more about these specific causes of high blood pressure in women and how to handle them naturally. 

This article focuses on research specific to individuals assigned female at birth during the studies and may not be generalizable to the entire population.


A pregnant woman getting her blood pressure measured as part of her prenatal checkup

During pregnancy, women produce 45% more blood(1) to provide nutrients and support fetal growth. In addition, changes in several key hormones also impact vascular dilation. The increased blood volume, plus unstable expansion of the blood vessels, makes hypertension likely among pregnant women. 

Also Read: Healthy Pregnancy 101: The Dos and Don’ts During Your First Trimester


Estrogen is a primary reproductive hormone among women that impacts blood pressure. It has vasodilatory properties(2), which can help the blood vessels relax and widen to allow proper blood flow. 

Women in their menopausal stage experience declining levels of estrogen. This diminishes their ability to control blood pressure inherently. Estrogen can also contribute to sodium and water retention, increasing blood volume. 

Plus, fat distribution during menopause typically concentrates in the abdominal area (visceral fats). This condition is also influenced by the decrease in estrogen. Research has shown that visceral fats(3) increase your risk of cardiovascular disorders, including hypertension.  

Also read: 8 Ways to Prepare Your Body for Menopause

Birth Control

A woman holding oral contraceptives

Less estrogen isn’t good news for your blood pressure, but so is its increased dosage, especially from oral contraceptives(4)

Birth control for women with high doses of estrogen can potentially impede vascular relaxation, increasing the pressure of blood flow. Additionally, it is widely believed to stimulate the production of a protein called angiotensinogen(5) from the liver. Angiotensinogen is a known vasoconstrictor (substances that help narrow the blood vessels). 

Polycystic Ovary Syndrome (PCOS)

Women diagnosed with polycystic ovary syndrome or PCOS are at a higher risk of experiencing high blood pressure. But that’s not to say all women with PCOS will have hypertension. The prevalence of high blood pressure(6) in women diagnosed with PCOS is 19.2%. 

The relationship between PCOS and hypertension is often indirect – yet they still intersect at some point. For example, women with PCOS may develop insulin resistance, wherein they have trouble processing insulin. 

When insulin deposits increase in the blood, it triggers androgen production(7), a predominantly male sex hormone produced in small amounts by women. High androgen levels can damage the ability of the blood vessels to dilate, potentially resulting in high blood pressure.

Also Read: Living With PCOS: Here’s What You Can Do About It

Non-Specific Causes of High Blood Pressure in Women

Hypertension in women is not solely traced back to hormone changes and problems in the reproductive area of the body. In fact, high blood pressure in women is a combination of multiple factors and can only be aggravated during the aforementioned specific events or conditions in a woman’s life. 

The following factors contribute greatly to anyone’s likelihood of having high blood pressure regardless of gender or sex.

Poor diet

Consuming foods high in sodium and saturated fats can lead to hypertension. Sodium promotes water retention, which increases blood volume.

On the other hand, eating foods rich in saturated fats can cause arterial plaques, constricting blood flow and increasing pressure. 

Chronic stress

During stressful situations, the body will release adrenaline and cortisol to activate the fight or flight response. As a result, your heart rate becomes elevated, and blood flow is restricted in certain areas to provide more energy to essential organs like your brain and muscles. 

While blood pressure can spike when you’re stressed, this condition is temporary until your brain deems it safe to bring several functions to normal. However, if you are under constant stress, high blood pressure occurs repeatedly and could damage your blood vessel lining.

Also Read: 5 Unhealthy Ways to Cope With Stress You Think Are Okay

Sedentary lifestyle

Inactivity, which is the hallmark of a sedentary lifestyle(8), can drastically increase your risk of hypertension. Lack of physical activities can lead to weight gain and insulin resistance, which, in turn, leads to hypertension. 

In addition, inactivity is known to cause low-grade inflammation, which contributes to vascular dysfunction. It also promotes the release of cortisol, a stress hormone that could trigger increased heart rate, which influences blood pressure.

Overconsumption of alcohol

There are many ways excessive alcohol intake can lead to high blood pressure. For example, too much alcohol promotes inflammation, increased heart rate, fluid retention, and vascular constriction – all of which contribute to the rapid spike in blood pressure.

Tobacco use

Nicotine, the main component of tobacco and tobacco products like cigarettes, can activate the fight or flight response of the body. In doing so, your heart rate is increased, blood vessels are constricted, and certain hormones are produced. These lead to temporary high blood pressure.

If you consistently smoke cigarettes or use any other tobacco products, you’ll likely become prone to developing recurring hypertension. 

Also Read: Blood Test for Smoking: What You Need To Know About the Nicotine/Cotinine Test  

Existing medical conditions

If you’ve been diagnosed with other chronic conditions, your chances of experiencing high blood pressure increase. This is because medical diseases, whether acquired or developed over time, directly connect with vascular activities.

Commonly associated disorders with hypertension include the following:

  • Diabetes
  • Obesity
  • Kidney disease
  • Thyroid problems
  • Atherosclerosis
  • Adrenal gland disorders
  • Sleep apnea

Also Read: 10 Actionable Health Goals for 2024

Frequently Asked Questions

Are women more susceptible to high blood pressure than men?

Contrary to popular belief, being a woman does not necessarily mean you are more susceptible to high blood pressure. Ultimately, your risk of developing the condition will depend on your lifestyle, genetic disposition, and existing medical disorders. All these factors may be exacerbated by hormonal changes due to specific conditions.

What is a dangerously high blood pressure for a woman?

A blood pressure of 180/120 mm/Hg or above is considered a hypertensive crisis or dangerously high for women. With such a result, you should seek immediate medical attention as it could be a result of another life-threatening disorder. 

What are the symptoms of high blood pressure in women?

It is common not to notice any symptoms of high blood pressure, especially if it’s not extremely high. If it does reach a hypertensive crisis, which is rare, you may experience dizziness, headache, double vision, shortness of breath, chest pain, nosebleeds, confusion, nausea, and vomiting. There are no specific symptoms of high blood pressure for women. 

The Bottom Line

You may come across several misconceptions about hypertension in women. Keep in mind, however, that the best way to keep your blood pressure within the normal value, regardless of gender, is to maintain a healthy lifestyle away from any triggers of cardiovascular disorders. During pregnancy, talk to your doctor about your risk of high blood. Do the same if you’re within the menopause perimeter or are experiencing reproductive problems.


1 Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94. doi: 10.5830/CVJA-2016-021. PMID: 27213856; PMCID: PMC4928162.

2 Sabbatini AR, Kararigas G. Estrogen-related mechanisms in sex differences of hypertension and target organ damage. Biol Sex Differ. 2020 Jun 1;11(1):31. doi: 10.1186/s13293-020-00306-7. PMID: 32487164; PMCID: PMC7268741.

3 Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008 Jun;32(6):949-58. doi: 10.1038/ijo.2008.25. Epub 2008 Mar 11. PMID: 18332882; PMCID: PMC2748330.

4 Shufelt C, LeVee A. Hormonal Contraception in Women With Hypertension. JAMA. 2020 Oct 13;324(14):1451-1452. doi: 10.1001/jama.2020.11935. PMID: 32955577; PMCID: PMC8528006.

5 Oparil S. Hypertension and oral contraceptives. J Cardiovasc Med. 1981 Apr;6(4):381, 384-7. PMID: 12263383.

6 Shi Y, Cui Y, Sun X, Ma G, Ma Z, Gao Q, Chen ZJ. Hypertension in women with polycystic ovary syndrome: prevalence and associated cardiovascular risk factors. Eur J Obstet Gynecol Reprod Biol. 2014 Feb;173:66-70. doi: 10.1016/j.ejogrb.2013.11.011. Epub 2013 Nov 25. PMID: 24368020.

7 Ndefo UA, Eaton A, Green MR. Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P T. 2013 Jun;38(6):336-55. PMID: 23946629; PMCID: PMC3737989.

8 Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean J Fam Med. 2020 Nov;41(6):365-373. doi: 10.4082/kjfm.20.0165. Epub 2020 Nov 19. PMID: 33242381; PMCID: PMC7700832.

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