Early Menopause Linked To High Blood Pressure. How To Lower Your Risk

• A study found that early menopause was associated with a greater risk of high blood pressure.
• The risk was highest when menopause occurred between the ages of 25 and 35.
• Experts say this occurs because estrogen plays several vital roles in the cardiovascular system.
• Hormone replacement therapy can help counteract these risks.
• Sleep, exercise, diet, taking prescribed medications, and monitoring blood pressure are also important.

A large new study has revealed that those who experience menopause earlier than usual are more likely to develop high blood pressure later in life. 

The authors note that the association was strongest among females who experienced menopause before age 40. The highest risk was observed between ages 25 and 35.

This research, published online ahead of print on July 29 in Menopause, highlights the importance of recognizing age at menopause onset as a cardiovascular risk factor.

Understanding this link could help women and healthcare providers better manage cardiovascular risks.

Menopause timing and high blood pressure risk

Researchers turned to the UK Biobank, a large health database that tracks the medical histories of hundreds of thousands of volunteers across the United Kingdom. 

For this study, they focused on postmenopausal females ages 40 and older who had no prior diagnosis of high blood pressure. 

Participants enrolled between 2006 and 2010 and were followed for more than a decade, allowing scientists to observe the development of health conditions over time.

The team collected a wide range of information, including lifestyle habits like smoking, alcohol intake, and physical activity, as well as medical history and lab test results. 

Females were classified based on when they experienced menopause:

• normal onset (after age 45)
• early menopause (between ages 40 and 45)
• premature menopause (before age 40)

The study also distinguished between natural menopause and surgical menopause, where both ovaries are removed.

By carefully analyzing this extensive data using sophisticated statistical models, the researchers identified patterns and relationships between the timing of menopause and the onset of high blood pressure, while accounting for many other factors that could influence these risks.

Younger age at menopause linked to greater risk of hypertension

Over the years of follow-up, a clear trend emerged: females who went through menopause at younger ages were more likely to develop high blood pressure compared to those who experienced menopause later. 

The risk was particularly significant for those experiencing premature menopause before age 40.

However, while females who had surgical menopause initially appeared to have higher rates of high blood pressure, this connection disappeared after considering other health and lifestyle factors. 

This suggests that the early loss of ovarian function alone, when caused by surgery, may not independently increase the risk of developing high blood pressure.

The researchers also explored how the risk changes continuously with age at menopause and found that the highest risk was among females who experienced menopause in their late 20s to mid-30s.

This finding challenges the conventional cutoff for defining premature menopause.

Beyond menopause timing, the study reaffirmed well-known risk factors for high blood pressure, such as obesity, smoking, poor diet, and existing health conditions like diabetes or heart disease. 

The authors suggest that females with menopausal symptoms should be attentive to these factors and work with healthcare providers to manage their cardiovascular health proactively.

Estrogen plays key role in healthy blood pressure

Heather Hirsch, MD, author of “The Perimenopause Survival Guide” and founder of The Academy for Advanced Women’s Health Medicine, says it all comes down to the role played by estrogen. Hirsch wasn’t involved in the study.

“We have known for nearly a century that estrogen has important, direct effects on the cardiovascular system,” she said. “Estrogen supports the production of nitric oxide, which helps blood vessels relax and dilate.”

According to Hirsch, this promotes healthy blood flow. Estrogen also helps preserve arterial flexibility and may reduce premature stiffening of the blood vessels.

“When a woman loses ovarian estrogen earlier than expected, she loses these cardiovascular effects years or even decades before she otherwise would have,” she explained.

Hirsch noted that estrogen also has certain indirect effects that increase the risk of metabolic syndrome and cardiovascular disease.

“Women may experience poorer sleep, changes in body composition, weight gain, higher blood pressure, worsening insulin sensitivity, and elevated blood sugar,” she said, adding that estrogen replacement is essential.

“In this population, we are not simply treating menopausal symptoms; we are replacing a hormone the body was expected to continue producing in order to help protect cardiovascular, skeletal, and overall long-term health,” said Hirsch.

Tips for blood pressure management

Jayne Morgan, MD, a cardiologist and Vice President of Medical Affairs at Hello Heart, echoed Hirsch’s advice about speaking with your doctor about hormone replacement therapy. Morgan wasn’t involved in the study.

In addition, Morgan advised taking any blood pressure medications you have been prescribed.

You may also wish to consider statins to improve your cholesterol profile, she said.

Morgan further pointed to sleep hygiene and exercise as an important part of blood pressure control.

“Also be certain to check your vitamin D levels and supplement if needed,” she said. “Vitamin D deficiency also impacts the heart and blood vessels and is more prevalent during the menopausal transition.”

“I also recommend a diet with increased protein as well as fruits, fiber, and vegetables,” Morgan added.

Finally, she suggests keeping an eye on your blood pressure with a home blood pressure monitor so you can act immediately if it starts to rise.

“Blood pressure will often increase silently, and the woman may not be aware between office visits,” said Morgan.

According to the American Heart Association (AHA), a systolic blood pressure (the top number) under 120 mm Hg and a diastolic blood pressure (the bottom number) under 80 mm Hg is considered normal.

If your systolic blood pressure ranges between 120 and 129 mm Hg and your diastolic blood pressure remains below 80 mm Hg, your doctor may advise you to make changes to your diet and exercise.

However, if either number is above this range, it’s important to speak with your doctor about whether you would benefit from using a medication to bring your blood pressure under control.