More women than men eventually develop hypertension, but they suffer less cardiovascular damage as a consequence. Primary hypertension in women has a greater volume component, often related to commonly associated obesity. Most lifestyle modifications have more to offer women, but women respond in a similar manner to various antihypertensive drugs. However, women appear to receive less benefit from antihypertensive therapy, as measured by morbidity and mortality data in multiple large clinical trials. Women who take oral contraceptives typically have a small rise in blood pressure, and in a small percentage, the rise is sufficient to induce hypertension. The prevalence is likely lower with currently used low-dose estrogen formulations. The use of estrogen for postmenopausal replacement therapy almost never raises the blood pressure, so that concerns about hypertension should not interfere with the use of this valuable therapy.
(Arch Intern Med. 1995;155:563-567)