A long-distance with runner with genetically low blood pressure from her mother’s side, no one was more surprised than Amy (not her real name) when her blood pressure started to rise.

“I was the gal who got dizzy from standing up too fast,” she said. “Nurses would always comment on how low my blood pressure was – I was sort of proud of it. Then I turned 50, and suddenly these numbers that had been rock steady most of my adult life started going up.”

With no real changes in diet or exercise, but a gain of about 10 pounds in the last couple of years, Amy wasn’t really sure what triggered the upward trend. Was it the extra weight? Was it menopause?

Menopause and high blood pressure (HPB)*

The question of “Does menopause cause an increase in blood pressure?” hasn’t yet been definitively answered, says University of California’s Berkeley Wellness. It’s possible estrogen helps to keep blood vessels flexible, allowing blood to flow more easily; when that estrogen protection disappears after menopause, vessels can become constricted and brittle.

It’s also possible the increase in blood pressure is simply a factor of aging, or it may be attributed to the weight gain many women experience around typical menopause age.

What is known is that women are less likely to suffer high blood pressure than men until about age 45; from around 45 to our mid-60s, women and men have roughly the same risk; over 65, women’s risk of hypertension is actually greater than men’s.

And hypertension – often called “the silent killer” – rarely has symptoms until the damage is done. Women need to be taking steps to reduce their risk before they reach menopause age, especially if they have other risk factors.

Dangers and damage from high blood pressure

Whatever the cause, high blood pressure – also called “hypertension” – can do a lot of damage.

It puts strain on the heart, damages arteries, and can disrupt the supply of blood to the brain. High blood pressure can affect the kidneys, the eyes, even reduce sexual function by reducing blood flow to the vagina, accelerate osteoporosis, and trigger sleep apnea.

With so much at risk, it makes sense to know your risks so you can take control of your heart health.

Risk factors for hypertension and how to counter them

In addition to being a woman over 45 (or in perimenopause/menopause), there are other risk factors that put you in danger of developing high blood pressure. Some are within your control, others less so, so it’s good to be on top of those things you can influence.

Less controllable

  • Family history – if it runs in your family, you have a higher risk of developing HPB
  • Age and gender – as discussed, women are better protected until age 65
  • Race – African Americans have a greater chance of developing HPB
  • Chronic kidney disease – and since HPB is damaging to kidneys, those with already damaged kidneys need to take extra precautions.

More controllable

  • Diet and exercise regimens. Boost the physical activity and potassium, which may be especially protective; ixnay the sodium, sugar, and red meat. To know what is good to eat, check out the American Heart Association’s Heart Healthy Diet. Try to get 150 minutes of exercise a week
  • Weight. Try to reduce if you can. Even 10 pounds can make a difference in your risk. Ideally, keep your waist under 40” for men and 35” for women (these numbers may vary by ethnicity, so ask your doc).
  • Alcohol, caffeine (?), tobacco, and stress. All of these weigh heavy on your heart – though the effects of caffeine are still unclear. Reduce where you can; eliminating is even better.
  • Diabetes and high cholesterol. Most people with diabetes will develop HPB, so if you are diabetic, be sure to work closely with your doc to control blood pressure. And, says the Heart Organization, more than half those with HPB also have high cholesterol.
  • Sleep apnea. Obstructive sleep apnea, which often develops in women in menopause, increases risk of high blood pressure. If you have sleep apnea, talk with your doc about a CPAP machine or other intervention to help you breathe more easily as you sleep.

What to do about HPB?

Be sure to have your blood pressure checked regularly, especially if you have risk factors. If you’re under 120/80, you’re said to be in the “normal” range; if you’re consistently between 120 – 129/80, you’re “elevated.” Over that, and you enter into hypertension range.

Best is to have your BP checked by a medical professional. The machine at the drugstore pharmacy is great, but you’ll likely get the most accurate numbers at a doctor’s office.

If tests show that you’re hypertensive or pre-hypertensive, make a plan with your doctor about how you’ll proceed. A personalized plan that includes diet, exercise, and other heart-healthy lifestyle choices could help you reduce the number of medications you’ll need, so map it out and stick to it.

Managing HPB can be done. By drastically reducing sodium, improving her diet, and sleeping more, Amy has so far been able to keep her numbers under the pre-hypertensive threshold without medication.

Bonus Resource: Be sure to check out the US Department of Health and Human Services info sheet, Your Guide to Lowering Blood Pressure. While the document dates back to 2003, there’s lots of good information in there, especially when used in conjunction with regular doc visits!

*As always, the information in this blog is for educational purposes only. If you suspect you have high blood pressure or any other health concern, please stop reading right now and get to your doc. You can read and enjoy this later, when you know all’s well.

Do you have or are you at risk of hypertension? How are you handling it? Tell us all about it in the comments or on genneve’s Facebook page or Midlife & Menopause Solutions, our closed Facebook group.

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Shannon Perry

Shannon is a celebrated author and global educator. Whether she’s interviewing a physician or producing a podcast, her appetite for research, facts, and truth culminates in credible health education and programming that women can rely on. An avid runner, cyclist, and climber, Shannon knows a thing or two about thriving in midlife and lives in Seattle with her cat, dog and boyfriend.

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