Some of the changes associated with the menopausal transition can increase the risk of hypertension (high blood pressure). For example, declining estrogen levels can narrow blood vessels, and menopause symptoms like sleep disturbances and weight gain may also play a role.
Blood pressure typically increases with age, but menopause can further increase your risk. If it goes unmanaged, chronic high blood pressure may also lead to complications.
Your doctor can help you make a plan to manage your blood pressure.
The risk of developing high blood pressure
Menopause causes changes in hormone levels — particularly estrogen — that
When estrogen levels decline during the menopausal transition, this effect also goes away to an extent. Blood is pumped through narrower blood vessels, raising your overall blood pressure.
Menopause may also increase the risk of high blood pressure in a few other ways.
For example, people experiencing menopause often gain weight, and a higher body weight can increase the risk of hypertension. Sleep disturbances are also common during menopause, and some research suggests that not getting enough high quality sleep can contribute to the risk of high blood pressure.
These factors can also contribute to lower levels of physical activity, which is also associated with high blood pressure.
Does the risk change by stage?
The risk of high blood pressure may change depending on which stage you’re experiencing.
According to a 2024 research review, people in postmenopause — which occurs after you haven’t had a menstrual period for 12 consecutive months — have a much higher risk of hypertension than people in premenopause or early perimenopause.
Postmenopausal people also have a higher risk of cardiovascular events, even at lower blood pressure thresholds, than people in other menopause stages. This makes it essential to manage blood pressure to lower your risk of complications.
A few other menopause-related factors can further increase high blood pressure risk.
For example, those experiencing early menopause — which is defined as being
Additionally, a
Some research also suggests that people experiencing menopause may be particularly sensitive to sodium (salt), which can affect blood pressure risk if consumed in high amounts. Overall, females appear to be more sensitive to salt than males, but this sensitivity may be even more pronounced during menopause.
How does hormone therapy affect blood pressure?
Hormone therapy can be an effective treatment for menopause symptoms, but depending on the type you take, it may affect your hypertension risk.
Hormone therapy formulated with oral conjugated equine estrogens and progesterone may increase the risk of high blood pressure more than medications containing estradiol alone or with progesterone.
The route of administration may also affect your risk. Oral estrogen-only hormone therapy
If you’re concerned about your blood pressure, ask your doctor about the safest type of hormone therapy for you and how long you should take it.
Chronic high blood pressure can increase the risk of serious long-term conditions or cardiovascular events,
- heart attack
- heart failure
- stroke
- atherosclerosis
- kidney disease
There are
Lifestyle changes
For many people, lifestyle changes are the first step to managing blood pressure.
- Dietary changes: You could start by reducing the amount of salt you eat and focusing on fruits, vegetables, and lean proteins. Your doctor or a registered dietitian may also recommend a specific eating plan, such as the Dietary Approaches to Stop Hypertension (DASH) diet.
- Physical activity: Regular physical activity can help lower the risk of developing high blood pressure or manage it if you already have it.
- Stress management: Chronic stress
can increase hypertension risk, so it’s important to find ways to manage it. You may be able to manage stress at home, but some people also benefit from medications and therapy. - Sleep: Getting enough high quality sleep is essential for overall health, but it can also help keep your blood pressure in a healthy range. If making changes to your sleep environment or bedtime routine aren’t enough, ask your doctor about medications or other treatments that may help.
- Weight management: Menopause can make weight gain
more likely , and many people find it harder to lose weight during the transition. However, you may be able to maintain a moderate weight with the strategies listed previously. If you need more help, your doctor may also recommend medications, like glucagon-like peptide-1 (GLP-1) receptor agonists.
Medications
Many medications are available to help manage blood pressure, including:
A generic medication called clonidine may also help some people
Your doctor will recommend the best medication based on your specific situation.
Healthcare professionals to connect with
If you want to make a plan to manage your blood pressure and you haven’t already talked with a healthcare professional, a primary care doctor can be a good person to start with.
A cardiologist may also be a good addition to your care team if you have other risk factors or a family history of high blood pressure or other heart issues.
If you need help determining what dietary changes to make, a registered dietitian can be helpful. Exercise professionals, like personal trainers, can also be good to talk with, especially if you have osteoporosis or other health conditions related to menopause that may affect your ability to exercise.
Need help managing stress or mental health conditions like anxiety or depression? Consider contacting a therapist or other mental health professional, such as a psychologist.
Menopause comes with many changes, some of which can affect your blood pressure. Talk with your doctor about your risk and steps you can take to keep your blood pressure in a healthy range.