Blood pressure generally increases after menopause due to hormonal shifts. Weight gain, which is common during menopause, can further contribute to elevated blood pressure.
During menopause, levels of estrogen, progesterone, and testosterone decline. These hormonal changes can slow down metabolism and change how the body stores fat, making weight gain more likely. Excess weight puts strain on the heart and blood vessels, which can contribute to higher blood pressure. In addition, lower estrogen levels can make the body more sensitive to sodium, meaning it may retain more fluid when you consume salt. This fluid retention increases blood volume, which may lead to elevated blood pressure. HRT may help reduce blood pressure by keeping arteries and veins flexible and supple so the blood can flow more easily.
This flexibility, known as arterial compliance, refers to the ability of the arterial wall to expand and contract with changes in blood volume. The opposite of this is arterial stiffness.
Women are at a higher risk of cardiovascular disease after menopause. While arterial stiffness increases with age in both men and women, a rapid decline in arterial compliance occurs during the perimenopausal period. This loss of flexibility in the arteries contributes to higher cardiovascular risk.
Hormone replacement therapy (HRT) has been shown to help partially reverse this increased arterial stiffness. Studies show that HRT can significantly slow or inhibit the age-related hardening of large arteries.