Having high blood pressure is common as you get older but it’s important to manage it – learn how hormones can help
• Women can experience a sharp increase in blood pressure during menopause
• Oestradiol can help to keep your blood pressure down
• Body identical HRT is suitable for women with high blood pressure or those taking blood pressure medications
It can be a surprise to learn you have high blood pressure, especially if you lead a healthy lifestyle and have not experienced this in the past. Blood pressure is the force of your blood pushing against your blood vessel walls as it flows away from your heart and around your body, and as you age, your blood pressure tends to rise. This is because your arteries can stiffen with age - it’s very common to have high blood pressure (known as hypertension) by the age of 60.
Although high blood pressure is more common overall in men, women are at higher risk of developing hypertension at certain stages of life, particularly during pregnancy and postmenopause [1]. Women experience a much sharper incline as they age – by the age of 60, women have higher hypertension prevalence than men [2].
And while high blood pressure may be common later in life, it is important that it is managed and treated as it puts a strain on your heart and blood vessels, and increases your risk of heart disease, heart attack, stroke and other diseases [3].
Stroke, menopause and HRT: what you need to know
How do I know if I have high blood pressure?
There are usually no symptoms of high blood pressure so you may not realise you have it. This is why it’s important to check your blood pressure regularly, particularly if you are at risk of having high blood pressure. According to the NHS, risk factors include:
• Your age – you’re more likely to get high blood pressure as you age
• Having close relatives with high blood pressure
• Your ethnicity – you’re at higher risk if you have a black African, black Caribbean or South Asian background
• Having an unhealthy diet
• Being overweight
• Smoking
• Drinking too much alcohol
• Feeling stressed over a long period of time
When you have your blood pressure taken your reading will consist of two numbers. In the UK, if your blood pressure consistently raises to 140/90mmHg or over, this would be diagnosed as high.
Do perimenopause and menopause cause high blood pressure?
Oestradiol (oestrogen) allows your blood vessels to relax and widen so that blood can flow through them easily, helping to keep your blood pressure down.
During perimenopause and menopause, levels of oestradiol fluctuate and then stay low. The drop in oestradiol doesn’t directly raise your blood pressure, but it is linked to a much higher risk of heart disease and heart attacks [4]. Cardiovascular disease is the leading cause of death in women.
Oestradiol also helps to keep your cholesterol level down. When oestradiol falls, the cholesterol in your blood rises, and the other protective effects of oestradiol are lost. If you have high blood pressure as well, these can all add up. Progesterone relaxes and widens blood vessels to lower blood pressure while testosterone also lowers blood pressure and increases blood flow to the arteries.
Menopause and cholesterol: what you need to know
Can I take HRT if I have high blood pressure?
HRT is usually the first-line treatment to improve symptoms of perimenopause and menopause [5].
There is sometimes confusion around women who have hypertension taking HRT and some women are needlessly advised against it. This confusion may be due to the older types of HRT. Synthetic oestrogen taken as a tablet and synthetic progestogens can increase blood pressure. However, taking body identical HRT can usually lower blood pressure. The body identical hormones work in various ways to lower blood pressure.
It is usually safe to take body identical hormones if you have hypertension or you are taking medicines to lower your blood pressure [6]. You will need to monitor your blood pressure regularly and some women find that they can reduce or even stop their blood pressure lowering medication with time when they take body identical HRT.
Heart health, menopause and HRT FAQ
What else can I do about high blood pressure?
Checking your blood pressure regularly and looking after your overall health can help lower your risk of heart disease.
Having a healthy weight reduces your chances of developing high blood pressure. Regular exercise can make your heart and blood circulatory system more efficient, lower your cholesterol level, and keep your blood pressure at a healthy level. Eat a healthy, balanced diet, and avoid processed foods. If you drink alcohol and/or caffeine, do so in moderation as these can raise blood pressure. Take any medicines you are prescribed for your blood pressure and be sure to speak to your healthcare professional about managing your perimenopausal or menopausal symptoms with HRT.
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