Are you a man of around fifty with a little high blood pressure? Probably all doctors, starting from the general practitioner to the cardiologist, will take care of you and will indicate the most appropriate therapies, to bring your blood pressure back to normal. Because hypertension is an important risk factor for cardiovascular disease.
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Gender medicine
Are you a woman, roughly the same age and do you have the same problem? You will not receive the same attention and the symptoms of hypertension are likely to be dismissed as menopausal ailments. Consequently, the underestimated and undertreated increase in blood pressure, but also for women hypertension is a risk factor for cardiovascular disease. a classic theme of “gender medicine”: which means that women, in many medical situations, are not taken as seriously as men. In other words: cardiovascular risk factors are “thought” to be typically male, but erroneously (the “classic” heart attack, to say, is considered a condition that mainly affects middle-aged men, but not always so). In short, gender stereotypes (a relatively young woman cannot have heart problems!) Condition medical care. And taking charge of the person.
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Female hypertension
Precisely on the topic of “hypertension” in menopausal women, the European Society of Cardiology (Esc) took the field with a Consensus Document just published onEuropean Heart Journal, which states: Physicians should be more careful in identifying hypertension in middle-aged women. Over 50 percent of women develop hypertension before the age of 60, but symptoms such as hot flashes or palpitations are often attributed to menopause. Here’s how female menopause can be a confounding factor for a correct diagnosis of a medical condition such as hypertension.
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Atrial fibrillation
Adds Angela Maas, director of the Women’s Cardiac Health Program, at Radbound University Medical Center in Nijmegen, The Netherlands: Increased blood pressure is referred to as “hypertension” in men, but in women often, erroneously, labeled as “stress” or ” menopausal symptom. We know that hypertension is less well treated in women than in men, which puts them at risk for atrial fibrillation, heart failure and stroke. All conditions that could be prevented with the early detection of this condition. And there are other factors that, according to the ESC document, must be taken into consideration to assess cardiovascular risk in women, including hypertension, which, therefore, must be carefully sought. And, we repeat, not confused with the symptoms of classic menopause
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Early menopause
Among the factors to be evaluated, the first is premature menopause (natural, non-surgical): those who encounter this condition before the age of forty are more likely to get cardiovascular disease. There is talk of an additional 3 percent risk for each year in advance. The second is pre-eclampsia, which can affect pregnant women and which involves an increase in blood pressure. Other conditions that should sound like a wake-up call, autoimmune diseases like rheumatoid arthritis or lupus that predispose to cardiovascular disease.
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Greater risks
There are different stages of life in which we must identify subgroups of women with high cardiovascular risk – says Angela Maas in an ESC statement. – Hypertension during pregnancy suggests that in these women they may then develop hypertension when they enter menopause and also associated with the development of dementia later in age. If hypertension is not started, these women between the ages of 40 and 50 are very likely to develop cardiovascular disease by the time they are seventy. Then the hypertension will be more difficult to treat. The ESC document, which is aimed not only at cardiologists, but also at gynecologists and endocrinologists, provides a series of indications to doctors on how to take care of the heart health of menopausal women, of women with complications after pregnancy, and of women with other diseases such as those of breast cancer or polycystic ovary (two other conditions in addition to the others already mentioned).
Ormonotherapy
Two more recommendations. The first concerns menopausal women and hormone therapy. According to the ESC Document, hormone replacement therapy may be useful for relieving menopausal symptoms such as hot flashes or night sweats in women over 45, but should be prescribed after a woman’s cardiovascular risk assessment. It is not recommended for women with high cardiovascular risk or who have had a stroke, heart attack or thrombosis.
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Transgender
The second recommendation refers to transgender women (people born “male”, but who have adopted a transition path to become women). These women – recalls Maas – take hormonal therapies during their life and the risk of thrombosis is very high. So the ESC document suggests to these people (for whom hormone therapy has positive psychosocial effects, as it modifies their body image) to adopt lifestyles that can counteract the negative effects. But the reference to correct lifestyles to combat hypertension and cardiovascular risks (needless to repeat, good nutrition, exercise, fight against stress, etc.) is a leitmotif of the whole ESC document. And it always applies to everyone, hypertensive and not.
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January 27, 2021 (change January 27, 2021 | 18:38)
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