"Medical Malpractice/Medical Negligence"

MEDICAL MALPRACTICE


"Medical Malpractice or negligence of medical authorities are happening in different countries but there is a very small chance that the responsible for medical negligence have been punished for irresponsible practicing of their profession.I would like to bring this topic to the attention of Medical Society that they should focus on how they will act when this incident happens,what should be the precautionary measures to be taken,should the medical practitioner who commited the negligence in performing his profession should be still allowed to continue practicing?Most Medical Practitioner are not taking this things seriously because they know they can get away with it.The main point here is how can be the rights of the patients be protected,what assurance could they have that they will get justice & the responsible in medical negligence will get the necessary punishment for their act.We should know that this should be taken seriously by the authorities in Medical Society because we are talking of lives here,people's lives...one negligence,one life will suffer & one family will be affected.So to all Medical Practitioners all over the world,If you don't love what you are doing or you don't know what you are doing,take a hike & get another job...Medical Society don't need another irresponsible practitioner,if you want to destroy your name do it alone ,don't drag the whole Medical Industry.

This is Dedicated to my father:
Reynaldo E. Colona M.D.
(Died last April,2001 bec. medical negligence)

Medical Malpractice

is an act or omission by a health care provider which deviates from accepted standards of practice in the medical community and which causes injury to the patient. Simply put, medical malpractice is professional negligence (by a healthcare provider) that causes an injury.

At the outset it is important to remember that virtually every country in the world operates its own unique legal system, and within some countries (e.g. the USA, the United Kingdom), there is more than one system operating within the same national borders. While much of this article mentions US law, it is important to remember that US law is not applicable world-wide, including when it comes to medical malpractice.

Medical malpractices may hide medical murders. When Japanese nurse Daisuke Mori was arrested, it was suspected because there were many medical malpractices in Japan.^[1][2]

At common law, the issue of Professional liability insurance is a subset of the law of negligence.

The parties

The plaintiff is or was the patient, or a legally designated party acting on behalf of the patient, or -- in the case of a wrongful-death suit -- the executor or administrator of a deceased patient's estate.

The defendant is the health care provider. Although a 'health care provider' usually refers to a physician, the term includes any medical care provider, including dentists, nurses, and therapists. As illustrated in Columbia Medical Center of Las Colinas v Bush (122 S.W. 3d 835, Texas, 2003), "following orders" may not protect nurses and other non-physicians from liability when committing negligent acts. Relying on vicarious liability or direct corporate negligence, claims may also be brought against hospitals, clinics, managed care organizations or medical corporations for the mistakes of their employees.

[edit] Elements of the case

A plaintiff must establish all four elements of the tort of negligence for a successful medical malpractice claim.^[3]

1. A duty was owed - a legal duty exists whenever a hospital or health care provider undertakes care or treatment of a patient.
2. A duty was breached -- the provider failed to conform to the relevant standard of care. The standard of care is proved by expert testimony or by obvious errors (the doctrine of res ipsa loquitor or 'the thing speaks for itself').
3. The breach caused an injury -- The breach of duty was a proximate cause of the injury.
4. Damages -- Without damages (losses which may be pecuniary or emotional), there is no basis for a claim, regardless of whether the medical provider was negligent.

[edit] The trial

Like all other tort cases, the plaintiff (or the plaintiff's attorney) files a lawsuit in a court with appropriate jurisdiction. Between the filing of suit and the trial, the parties (or their attorneys) are required to 'share information' through a process known as discovery. Such information includes interrogatories, requests for documents, and depositions. If both parties agree, the case may be settled early on negotiated terms. If the parties cannot agree, the case will proceed to trial.

The plaintiff has the burden of proof to prove all the elements by a preponderance (51%) of evidence. At trial, both parties will usually present experts to testify as to the standard of care required, and other technical issues during trial. The fact-finder (judge or jury) must then weigh all the evidence and determine which is the most credible.

The factfinder will render a verdict for the prevailing party, and assesses the compensatory and punitive damages, within the parameters of the judge's instructions. The verdict is then reduced to the judgment of the court. The losing party may move for a new trial. In a few jurisdictions, a plaintiff who is dissatisfied by a small judgment may move for additur. In most jurisdictions, a defendant who is dissatisfied with a large judgment may move for remittitur. Either side may take an appeal from the judgment.

[edit] Expert testimony

Expert witnesses must be qualified by the Court, based on the prospective experts qualifications and the standards set from legal precedent. To be qualified as an expert in a medical malpractice case, a person must have a sufficient knowledge, education, training, or experience regarding the specific issue before the court to qualify the expert to give a reliable opinion on a relevant issue. The qualifications of the expert are not the deciding factors as to whether the individual will be qualified, although they are certainly important considerations. Expert testimony is not qualified "just because somebody with a diploma says it is so" (United States v. Ingham, 42 M.J. 218, 226 [A.C.M.R. 1995]). In addition to appropriate qualifications of the expert, the proposed testimony must meet certain criteria for reliability. In the United States, two models for evaluating the proposed testimony are used:

The more common (and some believe more reliable) approach used by all federal courts and most state courts is the 'gatekeeper' model, which is a test formulated from the US Supreme Court cases Daubert v. Merrell Dow Pharmaceuticals (509 U.S. 579 [1993]), General Electric Co. v. Joiner (522 U.S. 136 [1997]), and Kumho Tire Co. v. Carmichael (526 U.S. 137 [1999]. Before the trial, a Daubert hearing^[4]will take place before the judge (without the jury). The trial court judge must consider evidence presented to determine whether an expert's "testimony rests on a reliable foundation and is relevant to the task at hand." (Daubert, 509 U.S. at 597). The Daubert hearing considers 4 questions about the testimony the prospective expert proposes:

• Whether a "theory or technique . . . can be (and has been) tested"
• Whether it "has been subjected to peer review and publication".
• Whether, in respect to a particular technique, there is a high "known or potential rate of error"
• Whether there are "standards controlling the technique's operation".

Some state courts still use the Frye test that relies on scientific consensus to assess the admissibility of novel scientific evidence. Daubert expressly rejected the earlier federal rule's incorporation of the Frye test. (Daubert, 509 U.S. at 593-594) Expert testimony that would have passed the Frye test is now excluded under the more stringent requirements of Federal Rules of Evidence as construed by Daubert.

In view of Daubert and Kuhmo, the pre trial preparation of expert witnesses is critical.^[5]

[edit] Damages

The plaintiff's damages may include compensatory and punitive damages. Compensatory damages are both economic and non-economic. Economic damages include financial losses such as lost wages (sometimes called lost earning capacity), medical expenses and life care expenses. These damages may be assessed for past and future losses. Non-economic damages are assessed for the injury itself: physical and psychological harm, such as loss of vision, loss of a limb or organ, the reduced enjoyment of life due to a disability or loss of a loved one, severe pain and emotional distress. Punitive damages are only awarded in the event of wanton and reckless conduct.

[edit] Statistics on malpractice and preventable medical error

Main article: Medical error

Medical malpractice claims can help identify areas where primary health care in the United States needs improvement, according to the American Academy of Family Physicians. The Academy refers to a study entitled "Learning from Malpractice Claims about Negligent, Adverse Events in the United States", in suggesting that the medical community can learn from tort claims. In that study, researchers looked at primary care malpractice claims settled between 1985 and 2000 in the United States. The study focused on a subset of 5,921 claims that were clear errors. The researchers found:

• 68 percent of the errors were in outpatient settings and resulted in more than 1,200 deaths.
• Negligence was more likely to have severe outcomes when they occurred in hospitals, but the total number of high severity outcomes and death was larger in the outpatient setting.
• Of the 10 most prevalent medical conditions with error-related claims, no single condition accounted for more than five percent of all negligent claims.
• Diagnostic error accounted for more than one-third of the claims.^[6]

A recent study by Healthgrades found that an average of 195,000 hospital deaths in each of the years 2000, 2001 and 2002 in the U.S. were due to potentially preventable medical errors. Researchers examined 37 million patient records and applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a study published in the Journal of the American Medical Association (JAMA) in October of 2003. The Zhan and Miller study supported the Institute of Medicine’s (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic. ^[7]Some researchers questioned the accuracy of the 1999 IOM study, reporting both significant subjectivity in determining which deaths were "avoidable" or due to medical error and an erroneous assumption that 100% of patients would have survived if optimal care had been provided. A 2001 study in JAMA estimated that only 1 in 10,000 patients admitted to the hospital would have lived for 3 months or more had "optimal" care been provided.^[8]

A 2006 follow-up to the 1999 Institute of Medicine of the National Academies study found that medication errors are among the most common medical mistakes, harming at least 1.5 million people every year. According to the study, 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings, and roughly 530,000 among Medicare recipients in outpatient clinics. The report stated that these are likely to be conservative estimates. In 2000 alone, the extra medical costs incurred by preventable drug related injuries approximated $887 million -- and the study looked only at injuries sustained by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs.^[9]

[edit] Criticism of medical malpractice lawsuits

Doctors' groups, patients, and insurance companies have criticized medical malpractice litigation as expensive, adversarial, unpredictable, and inefficient. They claim that the cost of medical malpractice litigation in the United States has steadily increased at almost 12 percent annually since 1975.^[10]Jury Verdict Research, a database of plaintiff and defense verdicts, says awards in medical liability cases increased 43 percent in 1999, from $700,000 to $1,000,000.

These critics assert that these rate increases are causing doctors to go out of business or move to states with more favorable tort systems.^[11] Not everyone agrees, though, that medical malpractice lawsuits are solely causing these rate increases. A 2003 report from the General Accounting Office found multiple reasons for these rate increases, only one of which was medical malpractice lawsuits.^[12] Despite noting multiple reasons for rate increases, the report goes on to state that the "GAO found that losses on medical malpractice claims-which make up the largest part of insurers’ costs-appear to be the primary driver of rate increases in the long run."

Tort reform advocate Common Good has proposed creating specialized medical courts (similar to distinct tax courts) where medically-trained judges would evaluate cases and subsequently render precedent-setting decisions. Proponents believe that giving up jury trials and scheduling noneconomic damages such as pain and suffering would lead to more people being compensated, and to their receiving their money sooner. This approach has been criticized for treating medical malpractice differently from other areas of tort law and for depriving Americans of their right to a trial by jury. Still, a number of groups and individuals have supported this proposal.^[13] Other tort reform proposals, some of which have been enacted in various states, include placing limits on noneconomic damages and collecting lawsuit claim data from malpractice insurance companies and courts in order to assess any connection between malpractice settlements and premium rates.^[14] Most (73%) settled malpractice claims involve medical error. A 2006 study published in the New England Journal of Medicine concluded that claims without evidence of error "are not uncommon, but most [72%] are denied compensation. The vast majority of expenditures [54%] go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant." Physicians examined the records of 1452 closed malpractice claims. Ninety-seven percent were associated with injury; of them, 73% got compensation. Three percent of the claims were not associated with injuries; of them, 16% got compensation. 63% were associated with errors; of them, 73% got compensation (average $521,560). Thirty-seven percent were not associated with errors; of them, 28% got compensation (average $313,205). Claims not associated with errors accounted for 13 to 16% percent of the total costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including lawyers, experts, and courts). Claims involving errors accounted for 78 percent of administrative costs.^[15][16]

[edit] Medical Malpractice and Medical Tourism

Medical malpractice interfaces with medical tourism (the practice of travelling overseas for the purpose of acquiring healthcare) at a number of levels.

Medical malpractice suits and the damages awarded are one reason why healthcare costs have spiralled in the USA and in some other developed countries, and it is in turn these high costs which are persuading some people requiring or desiring healthcare services to travel overseas and become medical tourists. The costs of surgery etc. are often lower outside of the USA and Europe. Also, in 1998 The Institute of Medicine released the now infamous report highlighting that 44,000 - 98,000 Americans die each year of medical errors. [2]

On the other hand, medical tourists may find it difficult to take effective legal action if and when they run into difficulties overseas because of different legal systems and different ethical standards and local customs. In some countries active in medical tourism, hospitals and their legal teams will work hard to avoid a civil case being heard in a US court. [3]

In 2006, the group CEO of Bumrungrad Hospital in Thailand, stated "If there's a mistake, we fix it..... But the idea of suing for multimillions of dollars for damages is not going to be something you can do outside the U.S." (in fact, this particular hospital requires all doctors within their group to carry malpractice insurance).

"About Children's Growth"

HEIGHT / WEIGHT CHART

Average height and weight of boys at different ages

AGE	WEIGHT (kg)	HEIGHT (cm)
Birth	3.3	50.5
3 months	6.0	61.1
6 months	7.8	67.8
9 months	9.2	72.3
1 year	10.2	76.1
2 years	12.3	85.6
3 years	14.6	94.9
4 years	16.7	102.9
5 years	18.7	109.9
6 years	20.7	116.1
7 years	22.9	121.7
8 years	25.3	127.0
9 years	28.1	132.2
10 years	31.4	137.5
11 years	32.2	140.0
12 years	37.0	147.0
13 years	40.9	153.0
14 years	47.0	160.0
15 years	52.6	166.0
16 years	58.0	171.0
17 years	62.7	175.0
18 years	65.0	177.0

(Source: Nutrient Requirements and Recommended Dietary Allowances for Indians, I.C.M.R. 1990.)

Average height and weight of girls at different ages

AGE	WEIGHT (kg)	HEIGHT (cm)
Birth	3.2	49.9
3 months	5.4	60.2
6 months	7.2	66.6
9 months	8.6	71.1
1 year	9.5	75.0
2 years	11.8	84.5
3 years	14.1	93.9
4 years	16.0	101.6
5 years	17.7	108.4
6 years	19.5	114.6
7 years	21.8	120.6
8 years	24.8	126.4
9 years	28.5	132.2
10 years	32.5	138.3
11 years	33.7	142.0
12 years	38.7	148.0
13 years	44.0	150.0
14 years	48.0	155.0
15 years	51.5	161.0
16 years	53.0	162.0
17 years	54.0	163.0
18 years	54.4	164.0

Height & Weight Pattern in the Growing Baby Expected weight gain You need to understand the importance of the role of weight gain, and therefore of your baby's expected or ideal weight. The baby's birth weight is the starting point for growth. Whatever be the birth weight, the growth rate in all the babies is approximately the same. The overall growth pattern depends on the proper food and adequate care of the baby. However illness, starvation, serious neglect or emotional disturbances would make his weight gain dip downwards. Height or length of the baby matters too Weight gain is not the only way to assess a baby's growth. Children are not meant to get fatter and fatter, but bigger overall. Getting taller is also included in the growth pattern of the baby. The baby's length will change much more slowly than the weight. Whatever be the baby's length at birth, approximately 2 cm (3/4") will be gained each month or just over 5 cm (2") in 3 months. Just as there is expected weight gain for a baby of any age, related to the birth weight, so there is a expected length at any age, related to the birth-length. There is a consistent relationship of weight and height in the normal growth pattern of the child.

Exception to normal growth patterns

a.	Pre-term babies : They are very slow to get started on their feeding, and therefore their growing. The weight tends to remain in low position for a long time
b.	Small - for date babies : They make startling growth during their earlier weeks, but on the whole they tend to occupy still a low position on the normal growth graph
c.	Babies who are ill immediately after birth or in the first weeks : These babies fail to start gaining weight or may actually loose some. Excellent care may lead to a spurt of "catch-up growth", so that the baby's personal growth curve shifts upwards towards the normal
d.	Babies who are bottle-fed from birth : These babies may loose no weight in the first days. They may gain very fast in the first days. They may gain very fast from the beginning, which also depends upon the formula food given. An even greater rise occurs in the babies weight when solids are added in addition to the over-concentrated milk. A baby who is gaining weight faster than nature intended, will not gain length to match it. There is a obvious disparity in the height gain compared to the weight. This cue should make you realise that the baby is starting to get obese rather than simply growing larger

"DO TAKE CARE ABOUT YOUR HEALTH...... ........."

Reasons for sleeping and waking up early.

Evening at 9 - 11pm: is the time for eliminating unnecessary/ toxic chemicals (detoxification) from the antibody system (lymph nodes). This time duration should be spent by relaxing or listening to music. If during this time a housewife is still in an unrelaxed state such as washing the dishes or monitoring children doing their homework, this will have a negative impact on health.
Evening at 11pm - 1am: is the detoxification process in the liver, and ideally should be done in a deep sleep state.
Early morning 1 - 3am: detoxification process in the gall, also ideally done in a deep sleep state.
Early morning 3 - 5am: detoxification in the lungs. Therefore there will sometimes be a severe cough for cough sufferers during this time. Since the detoxification process had reached the respiratory tract, there is no need to take cough medicine so as not to interfere with toxin removal process.
Morning 5 - 7am: detoxification in the colon, you should empty your bowel.
Morning 7 - 9am: absorption of nutrients in the small intestine, you should be having breakfast at this time. Breakfast should be earlier, before 6:30am, for those who are sick. Breakfast before 7:30am is very beneficial to those wanting to stay fit. Those who always skip breakfast, they should change their habits, and it is still better to eat breakfast late until 9 - 10am rather than no meal at all.
Sleeping so late and waking up too late will disrupt the process of removing unnecessary chemicals. Aside from that, midnight to 4:00 am is the time when the bone marrow produces blood. Therefore, have a good sleep and don't sleep late.

The top five cancer-causing foods are:

1.Hot dogs because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.
2. Processed meats and bacon Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.
3. Doughnuts Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.
4. French fries like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .
5. Chips, crackers, and cookies All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.

BRAIN DAMAGING HABITS

1. No Breakfast People who do not take breakfast are going to have a lower blood sugar level.
This leads to an insufficient supply of nutrients to the brain causing brain degeneration.
2. Overeating it causes hardening of the brain arteries, leading to a decrease in mental power.
3. Smoking it causes multiple brain shrinkage and may lead to Alzheimer disease.
4. High Sugar consumption too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.
5. Air Pollution The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.
6. Sleep Deprivation Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.
7. Head covered while sleeping Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.
8. Working your brain during illness working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.
9. Lacking in stimulating thoughts Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.
10. Talking Rarely Intellectual conversations will promote the efficiency of the brain

The main causes of liver damage are:

1. sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver.
Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.
We should prevent this without necessarily spending more time. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to "schedule."


DO TAKE CARE ABOUT YOUR HEALTH...... .........

5 Steps to Lower Blood Pressure

Every day, millions of Americans quietly battle a silent killer. High blood pressure is an elevation in the force of blood pushing against the walls of the arteries. It affects one out of every three Americans, according to the American Heart Association (AHA).

High blood pressure is considered a major risk factor for heart attack, heart failure and stroke. Untreated high blood pressure can cause the heart to eventually overwork itself to the point at which serious damage can occur.

High blood pressure can also cause injury to other areas served by delicate arteries that are damaged by the increased pressure. These include the brain, the eyes (retinopathy) and/or the kidneys (nephropathy).

In most cases, there is no cure for high blood pressure. Medication can control high blood pressure, but there are several lifestyle changes you can make to keep your blood pressure lower.

What You Can Do

There are several things you can do to lower your blood pressure. The top five are:

*Eat a healthful diet.

Studies have shown that people on the American Heart Association's Dietary Approaches to Stop Hypertension diet, or "DASH" diet, for only eight weeks experienced a significant reduction in blood pressure. The DASH diet emphasizes fruits, vegetables, whole grains and low-fat dairy while limiting saturated fat and red meat.

Excessive sodium intake also has been linked to an increased risk of high blood pressure. Limiting salt intake to 2,000 milligrams per day may help keep blood pressure low. A diet of 1,500 milligrams or less salt is especially effective at controlling blood pressure, according to the National Institutes of Health. Sodium is found in many foods, so keep an eye on the ingredients list to help rein in your sodium intake. In addition, avoid adding table salt to foods.

*Avoid smoking and excessive drinking.

The nicotine found in tobacco products constricts blood vessels, causing your hear to beat faster and raising blood pressure for a period of time. Smoking also damages blood vessel walls and hardens the arteries, which both increase the risk of high blood pressure.

Alcohol consumption has a significant impact on blood pressure in some people. Limit alcohol use to one drink per day for women and two drinks per day for men. One drink is defined as one 6-ounce glass of wine per day, one 12-ounce beer or one 1-ounce shot of distilled spirits.


*Get regular exercise.

Exercise three to four times per week helps regulate high blood pressure, keeping in mind that the regularity of the exercise is more important than the intensity of the workout. Individuals should consult their physician before starting an exercise program.To be effective, the exercise must be aerobic, meaning it must move large muscle groups and cause you to both breathe more deeply and to push your heart to work harder to pump blood.

However, your activity level does not need to be especially intense. For example, studies have shown that tai chi (an ancient Chinese workout involving slow, relaxing movements) may lower blood pressure almost as well as moderately intense aerobics.

*Lose weight.

Shedding pounds, especially in the abdominal area, can immediately lower blood pressure and help reduce the size of the heart. A loss of just 10 pounds can make a significant difference. In many people, a simple combination of weight loss and salt restriction eliminates the need for taking blood-pressure medication.

*Try to relax.

Emotional factors may play important roles in the development of high blood pressure. Studies have linked numerous activities to reducing blood pressure. These include cognitive-behavioral therapy, transcendental meditation, active religious faith and participation in activities related to a faith community. Other research has linked owning a pet with lower overall blood pressure. Relaxation techniques typically work best when they are employed at least once a day.

High Blood Pressure: Fast Facts

*Until age 55, more men than women have high blood pressure, but the numbers begin to even out until, beyond age 74, significantly more women than men have high blood pressure.

*Untreated, high blood pressure will cause the heart to overwork itself to the point where, eventually, serious damage can occur.

*High blood pressure is present in about half of people having first-time heart attacks and two-thirds of those having first-time strokes.

*More than 50 million people in the United States over age six (and one in four adults) have high blood pressure.

*Forty-five million Americans (22 percent of adults) have prehypertension, blood pressure that is on the borderline between normal and elevated.

*Nearly a third (30 percent) of people with high blood pressure don't know they have it. Another 36 percent either aren't on medication or don't have their blood pressure adequately controlled.

*The majority of people with mild to moderate high blood pressure do not have any noticeable symptoms.
One in three cases of heart failure in women results from high blood pressure.

*Blood pressure tends to get higher as women age. More than half of women over age 50 suffer from high blood pressure.

*High blood pressure is two to three times more common in women taking birth control pills than those not taking them. The risk is especially high in women who take the Pill and are overweight or obese.

*Women who have had a heart attack are less likely to experience a second one if they lower their blood pressure.

*During pregnancy, some women may develop high blood pressure even if they have never had the condition before. This gestational hypertension has been shown to increase the risk of high blood pressure and stroke later on in life. Some women who already have high blood pressure may see it worsen during pregnancy. Also, preeclampsia, a condition related to high blood pressure and the presence of protein in a pregnant woman's urine, is the second leading cause of maternal death in the United States.

*Sexual dysfunction in women may be linked to high blood pressure. Female patients are encouraged to discuss any sexual difficulties with their physicians.

*The prevalence of high blood pressure among African-Americans is the highest in the world. Black women are especially prone to high blood pressure. They have an 85 percent higher rate of medical care visits for high blood pressure than white women.