Blood pressure generally increases after menopause. Some
doctors think this increase suggests that the hormonal changes of menopause may
play a role in high blood pressure. Others think an increase in body mass index
(BMI) in menopausal women may play a greater role than hormonal changes.
Menopause-related hormonal changes can lead to weight gain
and make your blood pressure more reactive to salt in your diet — which, in
turn, can lead to higher blood pressure. For some women, hormone therapy (HT)
for menopause also may contribute to increases in blood pressure.
General causes for
high blood pressure
High blood pressure, also known as hypertension, is caused
by several factors including: age, heredity, race, sodium intake, obesity,
alcohol, and inactivity.
* Age. As people
age, there is an increased likelihood of high blood pressure.
* Heredity. High
blood pressure tends to run in families.
* Race. African
Americans tend to develop high blood pressure compared to Caucasians.
* Sodium intake.
Some people have higher sensitivity to sodium. Consuming foods that are high in
sodium cause an increase in blood pressure.
* Obesity. Blood
pressure increases as body weight increases.
* Alcohol.
Consuming more than one to two glasses of alcoholic beverages a day can
increase blood pressure.
* Inactivity.
Lack of exercise or leading a sedentary lifestyle can lead to obesity and an
increase in blood pressure.
Hypertension as a key risk factor in menopause
As blood is
pumped from your heart through your body, the blood puts force or pressure
against the blood vessel (or artery) walls. Your blood pressure is a reading,
or measure, of this pressure. When that reading goes above a certain point, it
is called high blood pressure, another name for hypertension. When you have
high blood pressure, it is partly because your blood vessels become narrower,
forcing your heart to pump harder to move blood through your body. These
changes cause the blood to press on the vessels walls with greater force.
High blood
pressure is called the "silent killer" because it usually has no
signs or symptoms. It is dangerous because it makes the heart work too hard. If
not controlled over time, high blood pressure can affect not only your heart
and blood vessels but also other organs, making them function not as well as
they should. The effects of uncontrolled high blood pressure include:
* Stroke. High blood pressure is the most
important risk factor for stroke. High blood pressure can cause a break in a
weakened blood vessel in the brain. This can cause bleeding in the brain, which
is a stroke. If a blood clot blocks a narrowed blood vessel, it can also cause
another type of stroke.
* Impaired vision. Blood vessels in the
eye can in time burst or bleed due to high blood pressure. Vision can become
blurred or impaired and can result in blindness.
* Kidney damage. The kidneys filter
wastes from our bodies. Over time, high blood pressure can narrow and thicken
the blood vessels of the kidneys. Thus the kidneys cannot do their job well,
and wastes build up in the blood. When kidney failure occurs, medical treatment
(dialysis) or a kidney transplant is needed.
* Heart attack. High blood pressure is a
major risk factor for heart attack. If the heart cannot get enough oxygen
because of narrowed or hardened arteries, chest pain (angina) can occur. If the
flow of blood is blocked, a heart attack results.
* Congestive heart failure. High blood pressure is the number one
risk factor for congestive heart failure, a serious condition where the heart
is not able to pump enough blood to meet the body's needs.
So, hypertension
is very most important risk factor that affects women in her postmenopausal
years. About 30 to 50% of women develop hypertension (RR >140/90 mmHg)
before the age of 60 and the onset of hypertension can cause a variety of
symptoms that are often attributed to menopause.
Women's systolic
pressure -- the top number in the blood pressure reading and the one that's
more closely associated with heart disease risk and stroke in people over age
50 -- increases by about 5 millimeters of mercury (mm Hg) with menopause. A
study done between 2001 and 2003 among people over age 60 showed that women had
a higher systolic blood pressure than did men in every state in America.
According to the report, women tended to think they didn't have high blood
pressure when, in fact, they did.
For healthy
adults, blood pressure less than 120/80 mm Hg is desirable. Untreated high
blood pressure can cause the heart to work too hard. Mild to moderate
hypertension may cause complaints such as non-specific chest pain, sleep
disturbances, headaches, palpitations, hot flushes, anxiety, depression,
tiredness, etc.
Women with a
family history of hypertension and women with a history of hypertension in
pregnancy are at increased risk to develop hypertension in this age period.
Hypertension often clusters with other risk factors such as overweight,
elevated insulin resistance, diabetes, and lipid abnormalities. In the Women’s
Health Study it was shown in almost 40,000 healthy women (≥45 years) that an
elevated blood pressure increases CV risk and that hypertension is a strong
predictor for the development of type II diabetes. Even in premenopausal women,
hypertension has been shown to be a potent risk factor for the presence of
coronary artery disease. Despite the high prevalence of hypertension in
middle-aged women, less than half of the patients receive adequate treatment,
especially in the older age group when the risk of hypertension-related
morbidity and mortality is highest.
Checking blood pressure
Do you know that there are people having high blood pressure
only when they visit their health care provider's office? This condition is
called white coat hypertension. It is quite easy and convenient to test your
blood pressure at the convenience of your home. There are over-the-counter
blood pressure measuring devices you can purchase in pharmacies and discount
chain stores that you can use at home. These include the blood pressure cuff
and a stethoscope and electronic monitors, such as digital readout monitors.
Here are some tips for what you can do to ensure as accurate
a blood pressure reading as possible:
* Don't drink coffee or smoke for 30 minutes before the
blood pressure check.
* Before your blood pressure is checked, sit still for five
minutes with your back supported and your feet flat on the ground. Try to rest
your arm on a table at the level of your heart.
* Go to the bathroom prior to the reading. A full bladder
can change your blood pressure reading.
* Get two readings, taken at least two minutes apart, and
average the results.
Controlling blood
pressure
To control your blood pressure both before and after
menopause, focus on a healthy lifestyle:
1. Get regular physical exercise. Exercise helps lower blood
pressure because it makes the heart stronger. With greater strength, the heart
can pump more blood with less effort. Being physically active for 30 to 60
minutes most days of the week can lower blood pressure by 4 to 9 mm Hg.
2. Follow a healthy eating plan. A healthy diet consists
mostly of fruits, vegetables, whole grains and low-fat or fat-free dairy
products. Limit consumption of red meat, processed foods and sweets. Several
studies have shown that those who follow the Dietary Approaches to Stop
Hypertension (DASH) eating plan, a healthy diet similar to what's described
here, may reduce blood pressure by up to 14 mm Hg.
3. Reduce dietary sodium. Salt (sodium) increases blood
pressure in most people with high blood pressure and in about 25 percent of
people with normal blood pressure. The recommended daily sodium intake is 1,500
to 2,400 milligrams; lower is even better.
4. Limit alcohol intake. In small amounts, alcohol can help
prevent heart attacks and coronary artery disease. But that protective effect
is lost when women regularly drink more than one drink a day. Above that
amount, alcohol can raise blood pressure by several points and can interfere
with blood pressure medications.
5. Achieve a healthy weight. Being thin isn't essential. But
for those who are overweight, losing as little as 5 percent to 10 percent of
body weight can lower blood pressure by several points. With less body mass to
nourish, the heart doesn't have to pump as hard and the pressure on the
arteries decreases.
6. If you still smoke,
stop!
Latest research
While there is a definite causal relationship between ageing
and tendency for higher blood pressure, the two new research studies have confirmed
that there are no reasons to believe that menopause itself causes high blood
pressure, and the hormonal changes impact on the high pressure development risk
yet to be validated.
A study led by Dr Casiglia of University of Padova, Italy
analyzed over 9,000 women aged 18 to 70 years. The researchers found that a higher risk of hypertension in menopausal
women was due to their higher age not due to the fact that they were
menopausal. The researchers concluded, “Conclusion: The cardiovascular
effects usually attributed to menopause seem to be a mere consequence of the
older age of menopausal women.”
A study led by Dr Cifkova from Prague, Czech Republic
analyzed 900 women aged 45-54 years as they went through menopause. Researchers
found there was no relationship between blood pressure and menopausal status - being
premenopausal, going through menopause, or being postmenopausal. Menopausal status had no effect on the risk
of high blood pressure. However, they found the main factor to increase blood pressure was an increase in BMI
(Body Mass Index) or body fatness.
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