Can Menopause Cause High Blood Pressure?

Menopause can affect the entire body, leading to a variety of symptoms including night sweats and vaginal dryness. However, the hormonal fluctuations and lifestyle changes that occur during menopause can also impact the cardiovascular system.

Whether you’ve experienced high blood pressure in the past or are noticing new and worrying symptoms, you aren’t alone and it’s normal to wonder how menopause might be affecting your heart health.

In this article, we’ll explore the connection between menopause and high blood pressure, how to recognise the signs, and the ways you can improve your blood pressure, and overall health, in menopause and beyond.

Can menopause cause high blood pressure?

Blood pressure generally goes up after menopause. High blood pressure, also known as hypertension, is considered one of the most important cardiovascular risk factors that affects women in their early postmenopausal years.

30-50% of women develop high blood pressure before the age of 60 (1) and over three-quarters of women over 60 are hypertensive (2).

High blood pressure during and after menopause can be caused by several factors including:

Hormonal changes: When oestrogen levels drop during menopause, the protective effects of oestrogen on blood vessels decrease. This makes it easier for the vessels to narrow and stiffen (1).
Stress: Menopause is associated with increased stress-induced elevated blood pressure (4).
Salt sensitivity: Postmenopausal women may be more sensitive to salt, which means their blood pressure is more affected by how much salt they consume (1).
Age: As people age, blood vessels become stiffer, which raises systolic blood pressure and this increase tends to be steeper in women than in men (1).
Weight gain: Metabolic changes in menopause can lead to weight gain and affect how the body stores fat, leading it to accumulate around the abdomen. This can have an adverse effect on blood pressure (3). Learn more about weight gain in menopause.

What is normal blood pressure during menopause?

Blood pressure is recorded as two numbers and is measured in units called millimetres of mercury (mmHg):

Systolic pressure: The top number is the pressure each time your heart contracts.
Diastolic pressure: The bottom number is the pressure in the artery as the heart relaxes before the next beat (5).

What is normal for each individual varies but as a guide:

Low blood pressure is less than 89/59mmHg.
A normal blood pressure is between 90/60mmHg and 120/80mmHg.
High blood pressure is 135/85mmHg or higher if your reading was taken at home, or 140/90mmHg or higher if your reading was taken in a clinical setting (6).

In adulthood, average blood pressure does vary according to age and gender.

For women aged 18-39, average blood pressure is 110/68 mmHg.
For women aged 40-59, the average blood pressure is 122/74 mmHg.
For women aged 60 and over, the average blood pressure is 139/68 mmHg (6).

Symptoms of high blood pressure

High blood pressure doesn’t usually cause any symptoms, and you can feel completely well in yourself even if you have been diagnosed with hypertension (7). However, high blood pressure in women is often mistakenly labelled as menopause symptoms with hot flushes and palpitations attributed to menopause rather than an indicator of cardiovascular concerns (8).

Rarely, high blood pressure can cause:

Headaches
Blurred vision
Chest pain
Nosebleeds
Chest pain
Shortness of breath
Dizziness (7, 9)

Dizziness can also have other causes. Learn more about dizziness during menopause.

Persistently high blood pressure may increase your risk of heart attack. If you develop any of the following symptoms, you should call 999 immediately:

Sudden pain or discomfort in your chest that does not go away. This pain can feel like squeezing or pressure inside your chest, burning or indigestion.
Pain that spreads to your left or right arm, or your neck, jaw, stomach or back.
Chest pain in addition to feeling sweaty, sick, lightheaded or short of breath (7).

Risks of having high blood pressure in menopause

If left untreated, high blood pressure can increase your risk of serious conditions by elevating the strain on your blood vessels, heart and other organs, including the brain, kidneys and eyes (7). It can lead to serious problems including heart disease, stroke, kidney disease, eye disease and vascular dementia.

How to control high blood pressure during menopause

Managing high blood pressure during menopause is crucial for reducing the risk of serious health conditions such as heart disease and stroke. Even a small decrease in blood pressure can significantly improve your long-term health. Fortunately, there are many effective ways to control blood pressure, from lifestyle changes to medical treatments.

Regular blood pressure checks

Frequent monitoring helps you stay informed about your blood pressure levels. Early detection of changes means you can act quickly to keep it under control. You can purchase blood pressure monitors to record your blood pressure at home but your GP or a local pharmacy can also check your blood pressure if you think you might have hypertension or you’re over 40 and haven’t had a blood pressure check in more than 5 years (7).

A DASH diet

A DASH (dietary approaches to stop hypertension) diet emphasises fruits, vegetables, whole grains, and low-fat dairy. It’s low in salt, sugar, and saturated fats, making it excellent for heart health (11).

Learn more about what constitutes a nutritious diet during menopause.

Increase exercise

Aim for at least 30 minutes of moderate activity most days. Exercise improves heart function, reduces stress, and helps lower blood pressure by keeping your heart and blood vessels in good condition (12).

Activities that are good for managing blood pressure include:

Brisk walking
Cycling
Dancing
Gardening
Tennis
Jogging
Swimming (12)

Swimming, particularly cold-water swimming, has a range of additional health benefits. Find out more about cold water swimming during menopause.

Limit or avoid alcohol

Drinking less alcohol can prevent blood pressure spikes and protect your heart. Stick to recommended guidelines or avoid alcohol altogether (7).

Stop smoking

Quitting smoking improves blood vessel health and reduces blood pressure, along with lowering the risk of heart disease (7).

Hormone replacement therapy (HRT)

For some women, HRT can help manage menopause symptoms and may positively influence blood pressure when used appropriately. One study found that when postmenopausal women with hypertension used HRT for a year, circadian blood pressure patterns were improved and that age-related rigidity of large arteries was significantly inhibited13.

However, there is also evidence that indicates oral oestrogen HRT can increase the risk of high blood pressure (14).

Key takeaways:

High blood pressure needs to be controlled before beginning HRT.
High blood pressure risk depends on the type of HRT used.
Individual responses vary.
Lifestyle changes are still pivotal.

Read our guide to HRT to understand more about whether it’s right for you.

Medication

If lifestyle changes aren’t enough, your doctor may prescribe medications to help lower and control your blood pressure effectively.

There are four main types of blood pressure medications:

ACE (angiotensin-converting enzyme) inhibitors
Angiotensin receptor blockers (ARBs)
Calcium-channel blockers (CCBs)
Thiazide diuretics (15)

Other ways menopause can impact heart health

Menopause doesn’t just influence blood pressure—it can also affect other aspects of heart health, increasing the risk of serious conditions.

High cholesterol: Falling oestrogen levels can lead to higher levels of ‘bad’ LDL cholesterol and lower levels of ‘good’ HDL cholesterol, raising the risk of heart disease (16).
Increased risk of diabetes: Hormonal changes can make the body less sensitive to insulin, increasing the likelihood of developing type 2 diabetes (17).
Metabolic syndrome: Menopause-related weight gain, particularly around the abdomen, combined with high blood pressure and unhealthy cholesterol levels, increases the risk of this condition (18).
Increased risk of Spontaneous Coronary Artery Dissection (SCAD): Postmenopausal women have a higher risk of SCAD, a rare but serious condition where a tear forms in a coronary artery, disrupting blood flow to the heart (19).

If you’ve got high blood pressure and are worried about how the changes in menopause will impact this, you’ve developed symptoms and you are worried about their underlying cause, or you want to know how to reduce your risk of serious health conditions in menopause, it’s always best to speak to a professional. To be matched with a menopause doctor who can review your symptoms, listen to your concerns and develop a tailored treatment plan, take our symptoms quiz.

DisclaimerAt Menopause Care, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

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