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The decline in oestrogen is thought to be one of the main reasons why blood pressure rises in menopause.

Oestrogen has a number of effects on blood pressure, including widening the blood vessels, which makes it easier for blood to flow.  It helps the body to regulate sodium levels. Too much sodium in the blood can raise blood pressure.  Oestrogen also helps regulate the renin-angiotensin-aldosterone system, which is a system of hormones that controls blood pressure.

So we break it down

  • Oestrogen helps the body to regulate sodium levels in a number of ways. First, oestrogen helps to increase the excretion of sodium in the urine. This is done by stimulating the kidneys to produce more of a hormone called natriuretic peptide.
  • Secondly oestrogen helps to reduce the absorption of sodium from the intestines. This is done by inhibiting the production of a protein called angiotensin-converting enzyme (ACE). This is an enzyme that helps to convert angiotensin I to angiotensin II. Angiotensin II is a hormone that causes the blood vessels to constrict and the kidneys to retain sodium.
  • The renin-angiotensin-aldosterone system (RAAS) is a system of hormones that controls blood pressure. The system is activated when blood pressure falls. When the system is activated, it releases a number of hormones, including renin, angiotensin II, and aldosterone.  During menopause, oestrogen levels decline significantly. This decline in oestrogen can lead to sodium retention and activation of the renin-angiotensin-aldosterone system.
  • Sodium retention can lead to high blood pressure because sodium attracts water. When there is more sodium in the blood, the blood volume increases. This increased blood volume puts more pressure on the blood vessels, which can lead to high blood pressure.

In addition to the decline in oestrogen levels, there are a number of other factors that can contribute to high blood pressure in menopause.  Many women gain weight during menopause. This weight gain can increase blood pressure. Oestrogen plays a role in regulating metabolism and appetite. As oestrogen levels decline, metabolism can slow down and appetite can increase.  There is the shift in body fat distribution. Before menopause, women tend to store more fat in their hips and thighs. After menopause, women tend to store more fat around their waist. This type of fat, also known as visceral fat, is more closely associated with high blood pressure.

Women develop insulin resistance is a condition in which the body’s cells become less responsive to the hormone insulin. Insulin resistance can lead to high blood pressure.  When someone is insulin resistant it can cause the body to produce more of the hormone aldosterone. Aldosterone is a hormone that causes the kidneys to retain sodium. This can lead to fluid retention and high blood pressure.  It can cause the blood vessels to become inflamed. Inflammation can damage the blood vessels and make them more likely to constrict (narrow). This can also lead to high blood pressure.

Finally, insulin resistance can lead to a condition called oxidative stress. Oxidative stress is a condition in which there is an imbalance between free radicals and antioxidants. Free radicals are unstable molecules that can damage cells. Antioxidants are molecules that help to protect cells from damage.

Oxidative stress can damage the blood vessels and make them more likely to constrict. This can also lead to high blood pressure.  Inflammation is a complex biological process that helps the body protect itself from injury and infection. Inflammation can be acute or chronic. Acute inflammation is short-term and usually goes away within a few days or weeks. Chronic inflammation is long-term and can last for months or even years.

Chronic inflammation can damage healthy tissues and organs. It is a risk factor for a number of serious health problems, including heart disease, stroke, cancer, and arthritis.

Top tips for managing high blood pressure in menopause:

  • Eat a healthy diet: A healthy diet for blood pressure includes plenty of fruits, vegetables, and whole grains. It is also important to limit salt, saturated fat, and cholesterol.
  • Exercise regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
  • Maintain a healthy weight: If you are overweight or obese, losing even a small amount of weight can help to lower your blood pressure.
  • Limit alcohol consumption: Alcohol can raise blood pressure. If you drink alcohol, do so in moderation.
  • Manage stress: Stress can raise blood pressure. Find healthy ways to manage stress, such as exercise, yoga, or meditation.
  • Quit smoking: Smoking damages the arteries and can raise blood pressure.

Nadira Awal

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