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Menopause and Hypertension: What is the Connection?

Menopause is the time when a woman stops having menstrual cycles, and arterial hypertension is the condition of high blood pressure in the arteries. Generally, menopause occurs around the age of 50 and this increases cardiovascular risk, as we’ll see below.

At this stage, women undergo a series of hormonal changes that have an impact on the body. Menopause and high blood pressure are related for different reasons that we’ll talk about here.

Unfortunately, in many cases, doctors are late to diagnose hypertension in climacteric women. The reason is that some of the symptoms of menopause may mask the hypertension.

What happens during menopause?

Menopause is diagnosed when a woman goes 12 months without a normal menstrual period. It can happen between 40 and 50 years of age. However, according to Mayo Clinic specialists, it most commonly begins around the age of 51.

The stage involves a decrease in the concentration of reproductive hormones. As they age, a woman’s ovaries produce less estrogen and progesterone, until they’re no longer fertile.

These hormones are involved in other processes as well as fertility regulation. In metabolism, for example, they help regulate weight, lipids, and insulin resistance.

Menopause begins gradually; it’s a transitional stage in itself. It’s accompanied by many symptoms, such as hot flushes, weight gain, and sleep problems. All of these can mask other conditions.

The point is that, in most women, heart disease starts later than in men. The reason is that estrogen plays a protective role in this regard.

The relationship between menopause and hypertension

Menopause and hypertension are related. It’s common for blood pressure values, measured in millimeters of mercury (mm Hg), to increase after menstruation stops.

There are many factors that play a part in the connection. First, the drop in estrogen may be a direct cause, as well as the increase in body mass that occurs at menopause.

Many middle-aged women are unaware that they suffer from hypertension. The reason is that some of the symptoms of this condition tend to be confused with menopausal symptoms.

For example, fatigue, headaches, sleep disorders and even palpitations are common in both conditions. This is why women can mistakenly believe menopause is the cause of the symptoms, when in fact it’s not.

This poses a great risk. Arterial hypertension can go unnoticed and, if it’s not diagnosed, adequate treatment won’t be provided. As a consequence of this error, the risk of heart disease in older women increases significantly.

Menopausal changes that can increase blood pressure

As mentioned, a number of important hormonal changes occur at menopause. The drop in estrogen is associated with weight gain. This, in turn, is linked to an increase in blood pressure values.

In addition, menopausal women also tend to develop insulin resistance. This means that their body cells can’t use the hormone to absorb glucose from the blood. As a consequence, there’s a higher risk of developing diabetes.

Moreover, blood lipid levels also increase during menopause. Thus, as a publication from the Climacteric: the journal of the International Menopause Society explains, the incidence of metabolic syndrome notably increases. This syndrome includes an increase in cholesterol and triglycerides, type 2 diabetes and increased cardiovascular risk.

Menopause and atherosclerosis

Women who experience typical menopausal symptoms, such as hot flushes and night sweats, are more likely to suffer from subclinical atherosclerosis. In fact, scientists estimate that the risk increases by almost 50%.

Subclinical atherosclerosis is a mild narrowing and hardening of the arteries. This narrowing, even if there are no obvious signs, also increases the risk of heart problems.

Chest pain, shortness of breath or palpitations are not menopausal symptoms in themselves. If they appear, it’s essential to consult a specialist.

Hormone replacement therapy and risk of hypertension

Hormone therapy during menopause has also been linked to high blood pressure. It involves giving hormones to women who have serious and severe menopausal symptoms.

There are different ways of carrying out the therapy, all with different levels of efficacy and safety. For example, treating vaginal dryness with topical drugs is safer because they don’t have a systemic effect.

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