Wondering if menopause could be linked to high blood pressure? You're not alone! As women transition through midlife, they often notice new or unexpected changes, including a bump in blood pressure. In this post, I'll explore the connection between menopause and high blood pressure, helping you understand why it may be changing and what you can do about it.

What Exactly Happens to Your Body During Menopause?

Before we get into the blood pressure talk, let's recap what’s happening in this season of life. Menopause marks the end of your menstrual cycle and is officially diagnosed after you've gone 12 months without a period. Most of us will go through menopause between the ages of 45 and 55, but some enter it earlier or later.

Estrogen, progesterone and even testosterone. decline, but can fluctuate wildly during perimenopause (the transitional phase before menopause) before finally settling down in post-menopause. While that may sound simple, the ripple effect of these hormone shifts is anything but straightforward.

Hormonal Shifts Are a Major Culprit

Estrogen, in particular, plays a role in keeping your blood vessels flexible, which helps maintain healthy blood pressure levels. As estrogen levels decline during menopause, your blood vessels may become less flexible, making it harder for blood to flow smoothly. This can lead to an increase in blood pressure for some people, although not everyone experiences a jump at menopause.

Let’s not forget that menopause usually happens around the same time as other age-related changes. As we get older, our blood pressure tends to naturally rise. Throw menopause into the mix, and you've got a perfect storm for potential blood pressure issues.

blood pressure rise in menopause — Menopause & blood pressure

The SWAN study researchers found three distinct patterns of blood pressure changes in women, and only 35% of those studied were found to have a distinct rise within one year of their last period.

How to Manage High Blood Pressure During Menopause

It’s a good idea to keep an eye on your blood pressure both at home, and in your doctor’s office. If you’re prone to “white coat hypertension” like I am, and experience a 15-30% jump in blood pressure when it’s measured in a healthcare setting, you may want to take your blood pressure regularly at home for a more accurate picture.

I check mine 3-4 times a year and record the readings in a note on my phone, so it’s easy to share them with health care providers if needed.

Be Savvy About Salt

While only one-quarter of people with hypertension are thought to be “salt-sensitive”, that number may rise in menopause. The exact mechanism isn’t fully understood yet, but research confirms that women are more salt-sensitive after menopause. If you’re like me and many of the women I talk to, this won’t come as a surprise as salty foods (like sushi) now make us bloat like a puffer fish!

Take a Holistic View of Heart Health

Menopause’s decline in estrogen levels isn’t the only thing impacting your risk of cardiovascular disease. There is a convergence of age-related risk factors that are also happening:

Sleep changes
Increased cholesterol levels (10-15%)
Possible changes in blood sugar and/or diabetes
Other emerging and non-traditional factors: hypertension in pregnancy, early menopause, autoimmune disease, etc.

Interestingly, vasomotor symptoms (ie hot flashes) might help identify people are at higher risk of heart disease. Compared to women who had none, those who reported having 1-5 hot flashes 6 days a week (for at least 2 weeks) experienced 50% more CV events according to research. And the severity of vasomotor symptoms appears more strongly associated than the frequency at this point.

Nutrition by Addition

As always, I recommend making what you add (instead of take away) the focus of your food and nutrition efforts. To help support healthy blood pressure, consider these recommendations:

Include potassium-rich foods more regularly, such as potatoes, bananas, avocadoes, and leafy greens. Talk to your doctor or pharmacist beforehand if you take medication for high blood pressure, as some have effects on potassium levels. Never take potassium supplements unless directed by a healthcare professional.
Enjoy high-fiber foods more often as research confirms the relationship between fiber and blood pressure. Fiber helps to feed our gut bacteria, who in turn produce beneficial short-chain fatty acids thought to impact blood pressure. Here are some of my best tips for adding fiber to your diet:
- Front-load your day with a high-fiber breakfast. This could be loaded oats with fruit, nuts, and seeds, a high-fiber cereal, or a veggie omelet and whole-grain toast.
- Look for opportunities to add more plants to your plate. All plants contain fiber, so finding ways to enjoy more of them (and more often) is a solid suggestion
- Add a plant-forward protein meal to your menu. Beans, lentils, and other legumes supply both protein and fiber, along with other vitamins and minerals. Most beans and lentils boast 12-15 grams of fiber per cup, so swapping chicken for chickpeas once in a while is worth considering.
Mocktails over cocktails. While having a drink may feel relaxing, it appears that the effect on blood pressure is mixed, with new research showing an overall increase in blood pressure with alcohol consumption, especially for regular and heavy drinkers.

The Take Home Message

Blood pressure changes can be an unwelcome symptom of midlife and menopause. While an important metric of overall health, it typically changes over months and years, not days or weeks. In other words, keep playing the long game of health and learn to make changes that are both enjoyable and sustainable.

Have you experienced changes in blood pressure during menopause? Let me know in the comments!

Need more help managing menopause without diets and food rules?

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