The CHAP trial demonstrated that treating mild chronic hypertension in pregnancy to a target of <140/90 mmHg significantly reduced preeclampsia and adverse perinatal outcomes without increasing small-for-gestational-age infants.
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.
Abstract Background 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. Objective 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. Content 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. Conclusions 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.
Bond et al. (2026) conducted a review in Adult women across the life cycle with hypertension, including reproductive-age, menopausal, and older women. The CHAP trial demonstrated that treating mild chronic hypertension in pregnancy to a target of <140/90 mmHg significantly reduced preeclampsia and adverse perinatal outcomes without increasing small-for-gestational-age infants.