Premature menopause tied to higher high blood pressure risk

Premature menopause high blood pressure risk was higher in a large UK Biobank study, with women who reached menopause before age 40 more likely to develop hypertension than those whose menopause occurred after 45. The finding matters because high blood pressure is a major cardiovascular risk factor and can often be detected and treated early.

The study, published in the journal Menopause, analyzed 107,836 postmenopausal women enrolled in the UK Biobank from 2006 to 2010. Researchers followed participants for a median of nearly 15 years, through the end of 2023, and tracked new diagnoses of high blood pressure.

Researchers grouped women by age at menopause: normal, defined as after 45; early, ages 40 to 45; and premature, before 40. They also considered whether menopause was natural or surgical.

Does premature menopause raise high blood pressure risk?

According to the study authors, 18,508 women, or 17.2% of the study group, developed hypertension during follow-up. The share rose as menopause occurred earlier: 16.6% among women whose menopause occurred after 45, 18.8% among those with early menopause and 22.6% among those with premature menopause.

After accounting for more than 50 factors, including weight, lifestyle, family history and laboratory measurements, premature menopause remained linked to a 12.3% higher risk of developing hypertension compared with menopause after age 45, the researchers reported.

The association was strongest among women whose menopause occurred between ages 25 and 35, according to an additional analysis that treated age at menopause as a continuous measure. That result suggests the highest cardiovascular risk may be concentrated among women who reach menopause well before the standard cutoff of 40.

Surgical menopause initially appeared to be associated with higher hypertension rates, but the link did not remain after researchers adjusted for other cardiovascular risk factors, according to the study.

Why age at menopause may matter

Menopause involves hormone changes that can affect disease risk, and earlier menopause has previously been associated with higher rates of coronary heart disease and stroke, according to The Menopause Society. Evidence tying menopause timing directly to hypertension has been mixed, with prior meta-analyses reaching different conclusions.

One difficulty, the researchers noted, is separating possible direct hormone-related effects from other factors that often accompany the menopause transition, such as weight gain and metabolic changes. The UK Biobank analysis was designed to account for many of those related risks.

High blood pressure, or hypertension, means the force of blood against artery walls remains elevated over time. It can raise the risk of heart disease and stroke, and many people do not know they have it without screening.

What clinicians may take from the study

The study authors said clinicians should consider age at menopause as an independent cardiovascular risk factor, especially for women who enter menopause before 40. They said earlier detection and management of high blood pressure could help reduce longer-term cardiovascular risk in this group.

Dr. Stephanie Faubion, medical director for The Menopause Society, said the results point to possible long-term health effects of premature menopause and the need to screen regularly for cardiovascular risk factors such as hypertension. She also said hormone therapy is routinely recommended for women with premature menopause at least until the typical age of natural menopause, unless contraindications exist.

The study, “Premature menopause is associated with the development of high blood pressure: a UK Biobank cohort study,” was published in Menopause.

This story draws on original reporting from Medical Xpress.