Has YOUR blood pressure risen after menopause? Here’s how HRT could help


Women often notice a subtle increase in blood pressure after menopause, and the change in hormone levels could be to blame. Alternatively, some experts think an increase in body mass index in menopause is more likely to be responsible. No matter the cause, it’s really important to keep an eye on your blood pressure at any phase of your life. Taking HRT could help you to manage your blood pressure after menopause. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out how HRT lowers blood pressure.

One in three adults in the UK has high blood pressure, including 31 percent of men and 26 percent of women.

High blood pressure is more common in older people and women are more likely to have raised blood pressure after menopause.

Hormone Replacement Therapy, the most popular treatment for menopause, could help to decrease your blood pressure after this phase of life.

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Many women worry that taking HRT will cause high blood pressure, but this is not the case.

Dr Lee pointed out: “Women often remember that the Combined Pill causes high blood pressure and think that HRT will have the same effect but this is untrue.

“HRT contains natural estrogen, chemically identical to the natural estrogen their ovaries were making before menopause when they were working properly.

“The pill contains a much higher dose of synthetic, potent estrogen, designed to shut down ovarian activity.

“HRT does not stop ovulation – it is not contraceptive.”

Women may be interested to know that in fact, HRT tends to slightly lower blood pressure.

HRT estrogen has many physiological effects that can improve arterial compliance and lower blood pressure.

Natural estrogen is a powerful antioxidant, hence it helps prevent free radical damage, and lowers levels of chronic inflammation.

Dr Lee said it also:

  • Increases levels of nitric oxide which is a very powerful vasodilator.
  • reduces levels of endothelin, a strong vasoconstrictor.
  • Promotes the production of collagen and elastin and helps maintain healthy vascular walls.
  • Is thought to reduce salt sensitivity and can suppress the renin-angiotensin system in the kidney, preventing sodium retention.
  • Prevents the production of angiotensin II, which triggers the ‘fight, fright, and flight’ system, and hence estrogen helps switch off the sympathetic nervous system.
  • Has a favourable effect on the lipid profile – it lowers LDL ‘bad’ cholesterol and raises HDL ‘good cholesterol’.

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Don’t wait too long to start taking HRT as it could save your life.

The RCOG believes the first 10 years after menopause are a window of opportunity for women to get protective effects from heart disease by taking HRT.

However, starting HRT too late – over the age of 60 to 65 – means the opportunity to gain these benefits is likely to have been lost.

Dr Lee said: “For every 1000 women taking HRT at the right time, six lives could be saved, and eight women could be prevented from developing heart disease, although this needs to be balanced against five extra women developing a thrombosis (blood clots).”

However, if a woman has established cardiovascular diseases such as a heart attack or a stroke, it is less clear whether she should or should not be given HRT.

In one 2012 study, looking into the use of HRT after a heart attack, taking HRT was not associated with an increased risk of a further heart attack or death.

Women with this history should seek advice on this from their heart specialist and/or local specialist menopause clinic.

As you may know, there are different forms of HRT.

According to Dr Lee, women with high blood pressure might prefer the option of a transdermal HRT regime – with a patch or gel – as the hormones diffuse directly through the skin and do not pass through the stomach, meaning lower doses can be used to get the same effects in terms of symptom control.

She added: “It’s always best to use the lowest dose of hormone, by the most appropriate route of delivery, that achieves the desired effect.

“The pros and cons should be carefully weighed up for each person and discussed with their GP or menopause specialist.”

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