Can Menopause Cause High Blood Pressure?

Dear Doctor,

I am in the throes of menopause–night sweats, heat flashes, and brain fog. I was prepared for all of those symptoms, but I wasn’t ready for a spike in my blood pressure! I am pretty healthy–I work out 3-4 times weekly and watch my diet. So I was surprised that my blood pressure reading was 121/79mm Hg at my most recent doctor’s visit. The nurse mentioned that it might be because I am menopausal. Is that true? Can menopause cause high blood pressure? If so, what can I do to get it back on track?

Signed,

Sweaty and Confused

Hello Sweaty and Confused,

The nurse is correct. Blood pressure tends to go up around the menopausal and post-menopausal phases. Up to 50% of women develop high blood pressure before the age of 60, and there may be a connection to menopause, though we are not 100% sure what it is. There are, however, two theories.

Theory #1:Hormones and Blood Pressure

During the “menopausal transition (MT),” fluctuating levels of hormones, primarily estrogen, may lead to an increased risk of coronary heart disease (CHD). Some research suggests that estrogen helps control the fats, cholesterol and other substances on the artery walls, a condition called atherosclerosis. Declining levels of estrogen in menopausal and post-menopausal women make them more susceptible to hypertension and other cardiovascular issues. 

There’s even evidence that women have slightly elevated blood pressure during their periods due to a spike in progesterone, another reproductive hormone. 

Theory #2: Menopause and Weight Gain

Another theory is that our metabolism naturally slows down as we age, causing accelerated weight gain. Excess weight is one of the leading causes of hypertension. Even a 5% increase in weight correlated with 20% more cases of hypertension. During menopause, even women who were formerly very fit may struggle with weight gain. This could be due to genetics, less activity, stress or even hormonal changes. Menopause weight can cause other health issues such as:

• Type 2 Diabetes
• Cardiovascular Disease
• Sleep Apnea and other breathing issues
• Painful joints
• Loss of mobility

Watching your weight as you age is a good thing to do, along with some other lifestyle changes that may help.

Lifestyle Changes to Help with Menopause and High Blood Pressure

It can be daunting to suddenly deal with high blood pressure on top of all of the other menopause symptoms. Below are a few ways you can manage your blood pressure and hopefully bring that number back down:

• Get Moving: The best thing you can do is incorporate physical activity into your everyday routine. Aim for 150 minutes of moderate intensity exercise weekly. Try a mix of endurance, strength and balance exercises. Strength training can build muscle, which helps increase your metabolism. NOTE: Women with osteoporosis should refrain from high-impact cardio or heavy lifting, and always check with your healthcare provider before starting a new exercise program.
• Watch Your Diet: As we age, our metabolism slows down, so you may have to eat less today than in previous decades to maintain the same weight. Weight loss during menopause can be challenging, so take advantage of a nutritionist or ask your healthcare provider for tips and support. Incorporate more leafy greens, fish, legumes and nuts into your diet. 
• Limit alcohol and sugar: Sweets can increase your weight, and alcohol consumption is overall harmful to your cardiovascular health.
• Consider a Menopause Supplement: With so many competing priorities (work, family, socializing, etc.), women struggle to get all their daily nutrients. Consider adding a daily multivitamin; there are even brands that make them specifically for menopausal women. When deciding on a vitamin, look for:
  • Fiber: Fiber supports heart and digestive health
  • Protein: Helps with maintaining muscle mass and keeps you fuller for longer
  • Omega-3 Fatty Acids: These essential fats have anti-inflammatory properties and have been shown to support your heart and your emotional and neurological health.
  • Magnesium: Magnesium is critical during the menopausal years as it supports bone health, which declines a lot during these years. It can also help promote better sleep, which is often hard to get during the menopausal years.

If you need guidance or support to manage your blood pressure or any other menopausal symptoms, request an appointment so we can provide guidance and explore all of your options.

Best,

Dr. Christopher Sullivan

Christopher Sullivan, MD, FACOG, is a board-certified gynecologist practicing at Genesis OB/GYN in Tucson, AZ.