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PCOS increases your risk of several other health conditions, and high blood pressure is among them. Why, and what can you do to fight hypertension?

Polycystic ovary syndrome gives you quite an abundance of things on your medical "plate" already, but if that weren't enough, it also increases your risk of other adverse health outcomes. High blood pressure is one of the conditions women with PCOS of all ethnic backgrounds are more likely to develop, research has shown. 

This increased risk is a problem not just because uncontrolled hypertension can cause organ and vessel damage, vision loss, and even lead to a heart attack or stroke, but also because high blood pressure doesn't typically announce itself with obvious symptoms. That means you can suffer from it without knowing unless you regularly check your blood pressure. You can ask your doctor to do this during routine visits, but it's also a good idea to get your own monitor for home use. If your systolic blood pressure is typically over 140 mmHg while your diastolic pressure reads 90 mmHg or above, seek medical attention.

What should all women who live with PCOS know about hypertension?

1. The link between hypertension, PCOS, and obesity

People of any body type can suffer from hypertension, but overweight and obese people are at a much greater risk. Overweight or obese people produce higher levels of the hormone leptin — which makes your blood pressure shoot up. The fact that as many as eight in 10 US women with PCOS are either overweight or obese goes a long way toward explaining why PCOS patients have hypertension in larger numbers.

While losing weight is certainly harder if you have PCOS than if you don't, as your hormones are working against you, it should be a top priority for many different reasons, and that includes lowering your risk of high blood pressure. 

2. PCOS, insulin resistance, and hypertension: Another part of the puzzle

A large portion of PCOS patients have insulin resistance, which also increases your risk of developing hypertension. Insulin resistance also means your levels of "bad" cholesterol are likely to be higher, and this, in turn, makes you vulnerable to atherosclerosis, a condition in which plaque builds up in your arteries — and which people with hypertension are also at a higher risk of. 

3. Do androgens cause high blood pressure?

The high androgen levels seen in women with PCOS have been linked to a thickening of the walls of the carotid arteries, major vessels that supply the brain, face, and neck with oxygen. OK, you see the next bit coming — this process increases your blood pressure, and can lead to hypertension. Independently of this, excessive androgen levels also interfere with the functioning of the parts of the nervous system that manage your blood pressure, together with obesity and insulin resistance. 

Now, what can you do about your risk of high blood pressure?

4. Eating your way to a healthier blood pressure

Insulin playing such an important role in your blood pressure, it is essential to keep your insulin levels in check. Medications such as metformin may be prescribed, but the diet you eat also has a tremendous impact on your insulin levels. Women with PCOS are often advised to eat a low-glycemic index diet, a diet of foods that prevent sudden spikes and drops in blood sugar levels. 

5. Say no to excess salt

Did any of your relatives caution you against putting too much salt on your food because of your kidneys? Mine did, but a diet high in salt also affects something else — your blood pressure. If you take this story to its conclusion, too much salt can even lead to heart disease and stroke. 

You really shouldn't be having more than half a teaspoon or so of salt each day, but most Americans get three times that amount — and you may not even realize it if you're one of them. Many processed foods are pack chock-full of salt to make them tastier, and if you grow accustomed to it, you won't even notice while you're eating. The only sure-fire way to make sure you don't get (much!) more salt than you should is to make your meals from scratch (or have someone else in your household do it). 

6. What is the DASH diet?

"DASH" is an acronym that invokes feelings of physical activity, but it actually stands for "Dietary Approaches to Stop Hypertension". This kind of diet is, as its name suggests, great for people already suffering from hypertension as well as for those who are at risk. It includes the advice to:

  • Consume for or five servings of fresh vegetables and fruits a day. 
  • Help yourself to just as many servings of nuts, seeds, and legumes a week. 

The rationale? Besides these foods just being generally food for you, you'll also find plenty of calcium, potassium, and magnesium in them. They lower your blood pressure and bring down your sodium levels, too. 

7. Do you get any omega-3 fatty acids?

Omega-3 fatty acids have many health benefits, but reducing blood pressure is among them — one study showed that a diet rich in omega-3 lowered the blood pressure of young women within four months. You know omega-3 can be found in fatty fish and supplements derived from them, but you're also able to get it from nuts, seeds, avocado, olive oil, and several other oils. 

8. How does exercise impact your blood pressure?

Women with PCOS are advised to work out about five times a week, doing both cardio and strength training, for general health reasons and to combat weight gain. Because regular exercise increases insulin sensitivity, it has an important impact on your blood pressure as well. Even if you don't want to, or can't, engage in organized exercise five times a week, make sure to walk around, climb some stairs, do some vigorous housework, or cycle to work — any physical activity counts!

9. Captain Obvious time: No smoking

Anyone newly diagnosed with high blood pressure will be advised to quit smoking if they do, as smoking further contributes to narrowing arteries and makes your risk of heart disease and stroke that much higher. Even if you don't already have hypertension, quit smoking for your general health and to reduce your PCOS symptoms. 

10. Pharmacological approaches

Your doctor will absolutely advise you to make lifestyle changes like the ones discussed above if your blood pressure has been on the high side. If it doesn't subside after you take action, or if you are already living the healthiest life possible, it may be time for anti-hypertensives. These include:

  • Diuretics, also often called "water pills" — they help your body rid itself of surplus water and salt, bring your blood pressure down.
  • Calcium channel blockers reduce blood pressure because they interfere with the way calcium moves through the blood vessels. 
  • ACE inhibitors have a relaxing effect on the blood vessels, enabling your heart to get a bit of a break.
  • Beta blockers slow your heart rate.

It may take some experimentation before you find the right medication for you, and you may be prescribed a combination. Always keep your doctor informed about side effects, and keep monitoring your blood pressure at home to see if the drugs are working. 

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