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High blood pressure

High blood pressure and menopause

High blood pressure can have multiple causes, one of which being menopause. Blood pressure generally goes up after menopause, but you may not notice it. High blood pressure often flies under the radar. But if you are aware of it, you to take action. 

I have a healthy diet, I exercise twice a week, I've cut back on alcohol, and I still have high blood pressure. It's not something you can always control. - Natascha (age 53)

Many people develop high blood pressure when they are in their forties. The further along in the menopausal transition, the more important it becomes to monitor your blood pressure. After all, research shows that there is a relationship between high blood pressure and the decrease in sex hormones. Postmenopausal women are especially at risk. Therefore, it’s important to be aware of your blood pressure so that you can take action to bring it down. 

What is happening in your body?

Menopause is usually associated with hot flashes, sleep problems and mood swings. High blood pressure is a lesser known symptom of menopause, but one to watch out for nonetheless. 

Oestrogen is a hormone that is involved in many processes in the body. It is vital to heart health and blood vessel health. Oestrogen dilates the blood vessels allowing blood to flow effortlessly, reduces inflammation and keeps cholesterol levels low (which is important because high cholesterol can lead to heart disease). So it has many positive effects.  

When oestrogen levels begin to fluctuate and fall around menopause, this can affect your heart and blood vessels. Before menopause, your hormones play a big role in many daily functions. Therefore, it is even more important to take good care of your body during and after menopause when your hormone levels fall.  

Low hormone level is not the only risk factor for high blood pressure. It can also be caused by stress, obesity, an inactive lifestyle, excessive alcohol consumption, heredity factors or a combination of several factors. 

How can you tell if you have high blood pressure?

High blood pressure, or hypertension, is not a disease in itself but a risk factor in many diseases, such as heart attack, kidney failure and stroke. High blood pressure is often called the ‘silent killer’ because most people who have it don't have any symptoms. People with very high blood pressure can experience symptoms such as:  

  • Headache 
  • Chest pain 
  • Dizziness 
  • Difficulty breathing 
  • Nausea or vomiting  
  • Blurred vision or other vision changes 
  • Anxiety 
  • Confusion or restlessness 
  • Ringing or other sounds in your ears 
  • Nosebleed 
  • Heart palpitations 

The only way to determine if you have high blood pressure is to check your blood pressure levels. This can be done very easily with a blood pressure monitor. 

What can you do?

In general, maintaining a healthy and active lifestyle reduces the risk of high blood pressure. But what exactly constitutes a healthy lifestyle?  

  • A healthy diet is rich in antioxidants. Anti-inflammatory foods are associated with lower blood pressure. To be healthy, you need to eat a variety of colourful fruits and vegetables. Eat a rainbow every day! 
  • Cut back on salt. Most people have a diet that is high in salt, usually a result of eating too many processed foods. Our advice? Do not exceed a limit of six grams (a teaspoon) a day. If you cook with fresh foods at home, it's easier to control your salt intake.  
  • Get at least 30 minutes of physical activity each day. That is, on top of your daily activities. Research shows that a combination of cardio and strength training is beneficial for controlling blood pressure in postmenopausal women. Alternate jogging or cycling with low-impact activities such as Pilates or Crossfit workouts.  
  • Reduce stress and get plenty of rest. Stress can cause your blood pressure to spike.  
  • Do you smoke? Try to quit. Smoking triggers many diseases in general and it also increases the risk of high blood pressure. 

Medication for high blood pressure

The key for getting through menopause in a healthy way is to eat a balanced diet, exercise regularly and get plenty of rest. If lifestyle changes aren't enough to control your blood pressure, then medication may be necessary. 

What treatments can help?

Is your blood pressure too high and do you want to take action yourself to lower it? Then start by eating a diet rich in vitamins and minerals, and exercise regularly (at least 30 minutes in addition to your normal daily activities). If this doesn’t bring your blood pressure down, you could consider medication. 

Doxazosin for high blood pressure

Sometimes a healthy lifestyle isn't enough to control blood pressure. In this case, blood pressure medication, like Doxazosin, might be an option. Doxazosin is an alpha blocker, a medicine that works by relaxing the blood vessels. It makes it easier for the heart to pump blood efficiently, lowering blood pressure. 

Can hormone therapy help?

Hormone replacement therapy (HRT) is used to treat severe menopausal symptoms, such as mood swings, hot flashes and night sweats. Do you have any of these symptoms as well high blood pressure? Then hormone therapy could be the solution you've been looking for. HRT replaces the hormones a woman's body stops making during menopause. 

Sources
  • Blood Pressure UK (BPUK). (2021). Blood pressure, the menopause and HRT. https://www.bloodpressureuk.org/news/news/blood-pressure-the-menopause-and-hrt-.html
  • World Health Organizaton (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension
  • Kulkarni S, O'Farrell I, Erasi M, Kochar MS. (1998). Stress and hypertension. PMID: 9894438. 
  • Izumi Y, Matsumoto K, Ozawa Y, Kasamaki Y, Shinndo A, Ohta M, Jumabay M, Nakayama T, Yokoyama E, Shimabukuro H, Kawamura H, Cheng Z, Ma Y, Mahmut M. (2007). Effect of age at menopause on blood pressure in postmenopausal women. PMID: 17903686. 
  • Maas AH, Franke HR. (2009). Women's health in menopause with a focus on hypertension. PMID: 19247469. 
  • Silva TR, Oppermann K, Reis FM, Spritzer PM. (2021). Nutrition in Menopausal Women: A Narrative Review. PMID: 34201460. 
  • Robinson AT, Edwards DG, Farquhar WB. (2019). The Influence of Dietary Salt Beyond Blood Pressure. PMID: 31025198. 
  • Xi H, He Y, Niu Y, Sui X, Zhang J, Zhu R, Xu H, Zhang S, Li Y, Yuan Y, Guo L. (2021). Effect of combined aerobic and resistance exercise on blood pressure in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials. PMID: 34560198. 

Tips and advice

FAQ

I suffer from heart palpitations. Is this a menopausal symptom?

Menopausal women often experience heart palpitation symptoms due to fluctuating oestrogen levels. Oestrogen causes blood vessels to dilate. When oestrogen levels are low they will contract. This causes your heart to beat faster than usual or pound. But there's no need to worry as heart palpitations are usually harmless. More about heart palpitations. 

Reviewed by
Arco Verhoog, Pharmacist
Registration number:
19065378617
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