<p>Cardiovascular diseases (CVDs), particularly hypertension, is a predominant contributor to the overall disease burden. While WHO has renewed its commitment to addressing gender disparities, global and national policies, including the Sustainable Development Goals (SDG) 3.4, lack specific targeting of women as a priority population. Hypertension in women remains under-studied, under-recognized, under-diagnosed, and under-treated. Hence, our study examines the hypertension risks among women and men using WHO’s causal framework, National Family Health Survey 5 (2019–21), and logistic regression analysis. Our study highlights that behavioural and metabolic risks increase hypertension among both women and men, however few sex-and-gender-specific risks disproportionately impact women, exacerbating hypertension in women than men. The interplay of sex-and-gender-specific risks with underlying, behavioural, and metabolic domains emphasizes the need for tailored gender-responsive health systems to address hypertension burden disparities. Further research should explore the underlying multicausal mechanisms driving these hypertension disparities and develop targeted interventions to address them.</p>