Menopause Does Not Cause Increased Blood Pressure, Studies Find

Increases in blood pressure and cardiovascular disease risk occurring in women after menopause do not result from menopause itself, according to two new studies reported in the October Journal of Hypertension. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

While the two studies offer differing explanations for the postmenopausal increase in blood pressure, they lend new insights into how women's cardiovascular risk changes after menopause—and the best approaches to managing those risks.

Study Assesses Impact of Body Mass Index on Blood Pressure in Menopause
In a study led by Dr. Renata Cifkova of the Institute for Clinical and Experimental Medicine in Prague, Czech Republic, detailed blood pressure measurements were made in about 900 women aged 45 to 54. The women were classified as being premenopausal, late in the menopausal transition, or postmenopausal. The relationship between stage of menopause and blood pressure was analyzed, taking into account a wide range of other factors.

After adjustment for the effects of age, there was no relationship between blood pressure and menopausal status—blood pressure levels were similar for women who were premenopausal, going through menopause, or postmenopausal. Menopausal status also had no effect on the risk of high blood pressure (hypertension).

On further analysis, the factor most strongly related to blood pressure was the women's body mass index (BMI)—a standard measure of body fatness, which tends to increase with age. "The rise in blood pressure after the menopause appeared to be due to increased BMI, rather than to ovarian failure per se," reports Dr. Cifkova and colleagues.

Second Study Evaluates Blood Pressure Values in Women From 18 to 70
A second study, led by Dr. Edoardo Casiglia of University of Padova, Italy, included more than 9,000 women ranging in age from 18 to 70. Absolute blood pressure levels were higher for menopausal women than for fertile (premenopausal) women. Other potential cardiovascular risk factors were also greater in menopausal women.

However, as in the Czech study, the relationship between menopause and blood pressure was no longer significant after adjustment for age. Apparent menopause-related differences in several other risk factors—including BMI—also disappeared after adjustment for age.

On long-term follow-up, menopausal women had greater increases in blood pressure and cardiovascular disease risk, compared to fertile women. Again, however, the differences were no longer present after adjustment for age. "Menopausal women seem to have higher BP values and worse risk profile than the fertile ones, but this is simply due to their older age," according to the researchers.