Menopause and High Blood Pressure

Why is it that everything with menopause goes up, up, up? Our weight goes up, our temperature soars, and even our blood pressure is prone to spike! What gives?

While it’s easy to spot rising body temperatures (red faces and sweat-drenched clothes) and expanding waistlines (busted buttons and zippers and snaps — oh my!), an increase in your blood pressure may not be so apparent.

Take, for example, the recent experience of one of my colleagues. One night, she woke up in the middle of the night with a horrific headache at the base of her skull. So she popped an ibuprofen and managed to go back to sleep. The next night, deja vu. On the third night, she woke up and entered “headache base of skull lying down” in the web search engine.

We all know it’s not usually a great idea to self-diagnose based on Internet search findings, and indeed, my colleague found everything from migraines (she had these before, but said this headache felt different) to an abundance of spinal fluid to brain cancer to high blood pressure.

Trying not to panic (after all, it could raise her blood pressure), she called her doctor the next morning and managed to get an appointment the same day, citing her concern over elevated blood pressure. Even though she had low blood pressure her whole life, monitored her salt intake and exercised regularly, high blood pressure was the only diagnosis that seemed plausible.

Turns out, her self-diagnosis was spot on.

My colleague is not alone. According to the National Institutes of Health, hypertension is by far the most significant risk factor for women in the early postmenopausal years. About 30 percent to 50 percent of women develop hypertension before the age of 60. And it’s not fun: mild to moderate hypertension may cause complaints such as non-specific chest pain, sleep disturbances, headaches, palpitations, hot flushes, anxiety, depression, and tiredness. Just reading this can make a woman anxious!

The Mayo Clinic agrees, suggesting that blood pressure increases after menopause could be attributed to the hormonal changes of menopause or an increase in body mass index (BMI). Many doctors prescribe transdermal (cream or a patch) estradiol HT (hormone therapy) for women under 60 early in their menopausal journey to help keep cholesterol levels down since there is lower risk of thrombosis (blood clots) with transdermal HT. According to the National Institutes of Health, in women with severe menopausal complaints and who are at low risk for cardiovascular heart disease, the use of HT in the years proximal to menopause may be very helpful. According to the WHI, women who start HT before age 60 decreased their overall mortality.

To control your blood pressure both before and after menopause, the Mayo Clinic recommends:

• Maintain a healthy weight.
• Eat heart-healthy foods, such as whole grains, fruits, and vegetables.
• Reduce processed foods and salt in your diet.
• Exercise on most days of the week.
• Limit or avoid alcohol. (Sorry!)
• If you smoke, stop.

Your doctor will consider prescribing medicines if your blood pressure is 140/90 or higher — the threshold for high blood pressure. However, you may want to opt for beta blockers instead of calcium-channel blockers, as the latter have been linked to an increased risk of breast cancer. A study reported in the Journal of the American Medical Association noted that in women aged 55 to 74; use of calcium-channel blockers for 10 or more years was associated with higher risks of both ductal and lobular breast cancer.  Other medications used to treat hypertension include enzyme inhibitors, receptor blockers, and diuretics.

According to  Harvard Health Publications and Dr. Deepak Bhatt, professor of medicine at Harvard Medical School, and director of the Integrated Interventional Cardiovascular Program at Brigham and Women’s Hospital, “The risk of developing high blood pressure over a lifetime is extremely high if a person lives long enough. For post-menopausal women, this is particularly true. By the time they reach their 60s and 70s, 70 percent of women have high blood pressure. After age 75, that figure rises to nearly 80 percent, according to the Centers for Disease Control.”

If left untreated, high blood pressure can lead to stroke and heart failure. It also can also contribute to dementia, kidney failure, vision problems (especially for those with diabetes), and sexual dysfunction. (That last one got your attention, didn’t it?)

Remember, high blood pressure can sneak up on you- sometimes even before you have any symptoms.  Ask your HCP (healthcare professional) to check your blood pressure when you go for your yearly checkup! iHealth makes a wonderful wireless blood pressure wrist monitor for easy at-home checking.

Trust how you feel! Like my colleague, you know your body better than anyone else. I encourage you to stay in tune with your body so that when something doesn’t feel right you pick up that phone and reach out to your HCP.   No pressure!

Suffering in silence is OUT! Reaching out is IN!

Click here to download my free eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.