Menopause and high blood pressure

You may have had normal blood pressure for years.

Then, around perimenopause, you see your numbers creeping up. And after menopause, your blood pressure is much higher than it’s ever been. What happened?

It’s very common for people to have high blood pressure after menopause.

Before menopause, women tend to have lower blood pressure than men the same age. After menopause, that changes. Women in mid-life are far more likely to have high blood pressure than men the same age.

There are a lot of possible reasons why.

Why blood pressure can be high after menopause

• Estrogen levels drop: The hormone helps keep blood vessels open and relaxed. A loss of estrogen can cause blood vessels to narrow, making it harder for blood to pass through them. Also, lower estrogen may cause you to become sensitive to salt, leading you to retain fluid, which contributes to high blood pressure.
• Aging: As you get older, blood vessels become stiff, which means the heart has to work harder to pump blood through them.
• Weight gain: Some women gain weight around menopause. Being overweight makes your heart work harder to circulate blood throughout your body.
• High stress: In mid-life, women often juggle a lot. Along with work, they may be taking care of their children as well as their aging parents, which is challenging to balance.

More answers to common menopause questions

What’s considered high blood pressure?

Elevated blood pressure is anything between 120 and 129/80. Typically, high blood pressure is diagnosed if you’re consistently at or over 130/80. The top number is the systolic pressure, the pressure in your arteries when your heart beats, pumping blood. The bottom number is the diastolic pressure, the pressure within the arteries between heartbeats.

One of the numbers could be elevated and not the other. It’s far more common for people with high blood pressure to have a high top number (systolic) rather than a high bottom number (diastolic).

The danger of high blood pressure

You might have high blood pressure and experience headaches and shortness of breath as a result. Or you may have no symptoms, which is much more common.

If you have blood pressure that’s a little bit high — in the 120s on top and the low 80s on the bottom — you may not have any symptoms. You’re not in danger unless your blood pressure stays higher than 130/80 for several months.

Left untreated, your heart can suffer, having to pump more forcefully to move the blood through the arteries. That can, over time, weaken the heart. It’s like if you pinch a section of a garden hose; water has a much harder time moving through the hose.

How genes affect blood pressure

High blood pressure runs in families. If you have a parent who has or had high blood pressure, you’re at greater risk of developing it. That’s even if everything else is healthy – your weight, diet and exercise habits.

I have a patient who has a healthy weight, eats a balanced diet and runs marathons but still has high blood pressure. Both her parents had it.

The risk of untreated high blood pressure

Left untreated, high blood pressure can cause heart disease, which includes various conditions, such as coronary artery disease, when plaque builds up around the heart’s arteries.

Heart disease is the leading cause of death among men and women in the United States.

Before high blood pressure takes a toll on your heart, there’s a lot you can do to lower your blood pressure.

Tips to bringing down your blood pressure

• Get enough sleep — seven to nine hours a night.
• Maintain a healthy weight.
• Exercise at least 150 minutes a week, intensely enough that your breathing and heart rate speed up.
• Eat at least five servings of fruit and vegetables daily — produce contains compounds such as antioxidants that help your blood vessels relax. Fruits and veggies can also fill you up, making it less likely you’ll reach for highly processed food.
• Reduce your stress through meditation, mindfulness and/or breathing techniques.
• Limit salt — try not to add salt at all to your food. Some food comes with salt already added.
• Stop smoking.
• Limit alcohol — no more than one drink a day for women. For men, no more than two.

Can hormone replacement therapy affect blood pressure?

Hormone replacement therapy is not used to treat high blood pressure. Typically, the therapy doesn’t typically affect blood pressure readings.

Medications for high blood pressure are effective

Even though you can’t always feel high blood pressure, leaving it uncontrolled for too long can damage your heart.

To prevent that, it’s important to have a health care provider check your blood pressure at least once a year.

If lifestyle changes don’t lower your blood pressure enough, medication can. There are many options, several of them inexpensive, that work well to keep blood pressure down.

Patients sometimes ask me why they need to take medication to lower their blood pressure if they have no symptoms of high blood pressure. I tell them that treating their high blood pressure is like changing the oil in the car. It keeps the engine going.