By: Thomas Pickering, MD, DPhil, FRCP, Director of Integrative and Behavioral Cardiology Program
of the Cardiovascular Institute at Mount Sinai School of Medicine, New York.
It has been uncertain whether there is a true increase of blood pressure associated with the menopause, or whether there is just a gradual upward trend that is the consequence of aging. A Belgian study of 315 healthy women aged between 30 and 70 checked their blood pressure three times over a 5-year period by conventional clinic measurements, and once by ambulatory (24 hour) monitoring. During that time 44 of the women went through the menopause.
Both types of blood pressure measurement led to the same conclusion: that there is an increase of systolic pressure of about 5 mmHg that is the result of the menopause itself, that is distinct from the effects of aging and putting on weight, which also tends to happen at the time of the menopause. There appeared to be no effect of the menopause on diastolic pressure, and men of the same ages as the women showed no similar change of blood pressure.
Part of the previous confusion as to whether the menopause directly affects blood pressure has been due to the fact that blood pressure (particularly systolic) tends to go up with age. What this study was able to show was that, over the same span of 5 years, women who went through the menopause showed a bigger increase of systolic pressure than those who did not. The fact that only systolic pressure was affected led the authors to suggest that the lack of estrogens, which accompany the menopause may result in an increased stiffness of the arteries.
Where it was published
JA Staessen and colleagues. Conventional and ambulatory blood pressure and menopause in a prospective population study. Journal of Human Hypertension 1997;11:507