Have you ever been to the doctor only to be told that your blood pressure reading is higher than normal? Maybe you’ve experienced that unsettling moment, feeling perfectly fine, only to see the numbers on the monitor creeping higher than expected. If you’re going through menopause, this scenario might hit home. You might find yourself thinking, “Wait, what’s changed?”
If you haven’t had the chance to check or have your blood pressure checked, this may be the right time to do it.
That’s because as you move through this chapter of your life, your body is undergoing transformations that can sometimes feel out of your control. Menopause isn’t just about the hot flashes and mood swings we all hear about—it’s also a time when your body undergoes significant changes that can affect your heart health, particularly in terms of blood pressure and cardiovascular risk.
Two key factors during this transition are the decline in oestrogen levels and potential weight gain. Both play a significant role in increasing your risk of hypertension and cardiovascular disease (CVD).
Understanding these changes is the first step in taking control of your health. Let’s explore how these factors influence your blood pressure, how they are connected to a condition called Metabolic Syndrome, and, most importantly, what you can do to protect your heart.
Oestrogen: Your Heart’s Natural Protector
Oestrogen has been your ally in maintaining cardiovascular health throughout your reproductive years. This hormone does more than regulate your menstrual cycle—it’s vital for keeping your blood vessels flexible and your blood pressure stable. It achieves this by promoting the production of nitric oxide (NO), a molecule that helps relax blood vessels, allowing for smooth blood flow and healthy blood pressure levels [1].
As menopause approaches, your oestrogen levels start to decline, leading to reduced nitric oxide production. Without this natural relaxer, your blood vessels may become more resistant to blood flow, a condition known as endothelial dysfunction. This early sign of hypertension increases your risk of developing heart-related issues, such as heart attacks and strokes [2]. The loss of oestrogen can set off a chain reaction that impacts your cardiovascular health, making monitoring and managing your blood pressure during this time crucial.
Weight Gain and Metabolic Syndrome
Alongside hormonal changes, many women experience weight gain during menopause, and where the weight is gained, particularly around the abdomen, matters greatly. As oestrogen levels drop, your body may start storing more fat in the abdominal area, known as visceral fat. This type of fat is metabolically active, increasing inflammation, insulin resistance, and, importantly, raising your blood pressure [3].
This weight gain, combined with hormonal changes, can lead to what is known as Metabolic Syndrome. Metabolic Syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, and type 2 diabetes. To be diagnosed with Metabolic Syndrome, you need to have at least three of the following five criteria [4]:
Source: Huang (2009)
When these conditions are present together, they significantly elevate your cardiovascular risk. But here’s the empowering part—understanding these risks means you can take steps to manage them effectively. By making thoughtful lifestyle changes, you can help control your blood pressure and reduce the impact of these changes on your heart health.
Understanding Hypertension: The ‘Silent Killer’
Hypertension is often called the “silent killer” because many people with high blood pressure don’t experience any symptoms. This can lead to a false sense of security, making it easy to overlook the importance of regular blood pressure checks. Knowing your blood pressure levels and understanding what the numbers mean is important. Here’s a quick guide to the different categories of blood pressure readings, according to the Australian Heart Foundation:
Source: Australian Heart Foundation [5]
Knowing where your blood pressure falls within these categories can help you and your healthcare provider develop a plan to manage it effectively. Regular monitoring is essential, especially during menopause, when hormonal changes can impact your cardiovascular health.
How To Measure Your Blood Pressure At Home
Taking care of your health in your midlife years means staying proactive about key indicators like blood pressure. As women reach midlife, the risk of developing high blood pressure increases due to hormonal changes and lifestyle factors.
Regularly checking and recording your blood pressure is crucial because it helps identify any deviations from healthy levels early on, allowing for timely intervention.
The good news is that you can easily monitor your blood pressure from the comfort of your own home.
Here’s a simple guide from The Heart Foundation to help you get started.
The DASH Diet: A Healthy Approach to Managing Hypertension
The DASH diet (Dietary Approaches to Stop Hypertension) is a powerful tool for managing high blood pressure. It emphasises whole foods that are rich in nutrients like potassium, calcium, and magnesium while limiting sodium and unhealthy fats. The following steps, grounded in the principles of the DASH diet, can help you effectively manage your blood pressure and reduce your cardiovascular risk [6]:
Increase Fibre Intake
- Goal: Consume 25-29 grams of fibre daily or more.
- Why It Matters: Fibre-rich foods help manage blood pressure by improving digestion, reducing cholesterol levels, and promoting a healthy weight.
- Food to include: Fruits, vegetables, legumes (such as beans and lentils), whole grains, and cereals containing oats. These foods are staples in the DASH diet and support overall heart health. Another food you can add to your daily diet is Beetroot.
Beetroot juice is gaining attention as a powerful, natural way to manage blood pressure, thanks to its high nitrate content. When consumed, the nitrates in beetroot juice are converted into nitric oxide in the body, which helps to relax and widen blood vessels, leading to lower blood pressure.
Studies have shown that regular consumption of beetroot juice can be particularly effective in reducing systolic blood pressure, making it a heart-healthy addition to your diet. Incorporating beetroot into your meals, such as in a vibrant beetroot salad, is an easy and delicious way to enjoy these cardiovascular benefits while adding a burst of colour and flavour to your plate.
Increase Potassium Intake
- Goal: Aim for a daily intake of 3500-5000 mg of potassium.
- Why It Matters: Potassium helps balance the effects of sodium and relaxes blood vessel walls, which can lower blood pressure.
- Food to include: Bananas, leafy green vegetables (like spinach and kale), legumes, avocados, and salmon. These foods are central to the DASH diet and help counteract the negative effects of sodium.
Limit Sodium Intake
- Goal: Reduce sodium intake to no more than 2000 mg daily, roughly equivalent to 5 grams of salt (about a teaspoon).
- Why It Matters: Excess sodium can increase fluid retention and blood pressure. Monitoring and reducing sodium intake are essential for blood pressure management.
- How to Manage: Check food labels on processed foods to track sodium levels and try to minimise consumption of high-sodium foods. The DASH diet recommends using herbs and spices to flavour food instead of salt.
Limit Alcohol Consumption
- Goal: limit alcohol intake to less than one drink per day.
- Why It Matters: Excessive alcohol consumption can raise blood pressure and reduce the effectiveness of blood pressure medications.
- Practical Tips: Be mindful of portion sizes and choose days without alcohol to help manage intake. While not a primary focus of the DASH diet, moderating alcohol intake complements the diet’s heart-healthy guidelines.
Focus on Whole Foods and Healthy Fats
- Goal: Prioritize whole, minimally processed foods and include healthy fats in your diet.
- Why It Matters: Whole foods are nutrient-dense and help support heart health, while healthy fats like those found in nuts, seeds, and fish can help lower cholesterol and improve blood pressure.
- Food to include: Incorporate nuts, seeds, olive oil, and fatty fish, like salmon, into your meals. These foods provide healthy fats that are integral to the DASH diet and support overall cardiovascular health.
Get Moving with Regular Exercise
Regular physical activity is essential for maintaining a healthy weight and managing blood pressure. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, including activities like brisk walking, cycling, or swimming. Exercise helps lower blood pressure and boosts your mood and energy levels [7].
Strength training is also important. Building muscle increases your metabolism, supports bone health, and helps with weight management. Consider adding weight-bearing exercises to your routine to enjoy these benefits.
Monitor and Manage Weight
Weight management is key to reducing your risk of hypertension during menopause. Even modest weight loss can significantly impact your blood pressure and overall cardiovascular health.
Focus on sustainable changes to your diet and exercise routine rather than quick fixes. Remember, it’s not just about the number on the scale—pay attention to how your clothes fit and how you feel. Reducing visceral fat can help lower your risk of Metabolic Syndrome and protect your heart.
Prioritise Stress Management
Stress can take a toll on your blood pressure, making it important to find effective ways to manage it. Techniques such as breathing exercises [8] and yoga [9] can help you stay calm and centred.
Wrapping It Up
Menopause is a time of significant change but also an opportunity to take charge of your health. By embracing the DASH diet and its principles—focused on increasing fibre and potassium, reducing sodium, moderating alcohol, and prioritising whole foods—you can take proactive steps to manage your blood pressure and protect your heart.
Remember, this is your journey, and you have the power to navigate it with confidence. Regular check-ups with your healthcare provider will help you stay on track, and with these tools in your arsenal, you’re well-equipped to embrace this stage of life with a heart full of health and a mind full of possibilities.
References
1. Mendelsohn, M. E., & Karas, R. H. (2005). Molecular and cellular basis of cardiovascular gender differences. Science, 308(5728), 1583-1587. https://doi.org/10.1126/science.1112062
2. Pimenta E. (2012). Hypertension in women. Hypertension research: official journal of the Japanese Society of Hypertension, 35(2), 148–152. https://doi.org/10.1038/hr.2011.190
3. Mumusoglu, S., & Yildiz, B. O. (2019). Metabolic Syndrome During Menopause. Current vascular pharmacology, 17(6), 595–603. https://doi.org/10.2174/1570161116666180904094149
4. Huang P. L. (2009). A comprehensive definition for metabolic syndrome. Disease models & mechanisms, 2(5-6), 231–237. https://doi.org/10.1242/dmm.001180
5. Australian Heart Foundation. (n.d.). Blood pressure guidelines. Retrieved August 10, 2024, from https://www.heartfoundation.org.au/conditions/hypertension
6. Onwuzo, C., Olukorode, J. O., Omokore, O. A., Odunaike, O. S., Omiko, R., Osaghae, O. W., Sange, W., Orimoloye, D. A., Kristilere, H. O., Addeh, E., Onwuzo, S., & Omoragbon, L. (2023). DASH Diet: A Review of Its Scientifically Proven Hypertension Reduction and Health Benefits. Cureus, 15(9), e44692. https://doi.org/10.7759/cureus.44692
7. Australian Government Department of Health. (2021). Australia’s physical activity and sedentary behaviour guidelines and the Australian 24-hour movement guidelines. Retrieved from https://www.health.gov.au/resources/collections/australias-physical-activity-and-sedentary-behaviour-guidelines-and-the-australian-24-hour-movement-guidelines
8. Natarajan, A., Emir-Farinas, H., & Su, H. W. (2024). Mindful breathing as an effective technique in the management of hypertension. Frontiers in physiology, 14, 1339873. https://doi.org/10.3389/fphys.2023.1339873
9. Joshi, A. M., Raveendran, A. V., & Arumugam, M. (2024). Therapeutic role of yoga in hypertension. World journal of methodology, 14(1), 90127. https://doi.org/10.5662/wjm.v14.i1.90127
