- Women experiencing perimenopause or postmenopause are normally at a higher risk of developing high blood pressure than premenopausal women.
- Previous research shows a decreased level of estrogen may cause that higher hypertension risk.
- A new study helps to explain just how estrogen may help protect against hypertension in premenopausal women.
According to the U.S. Department of Health and Human Services’ Office on Women’s Health, it’s not uncommon for
Additionally, past research shows that about 41% of women develop hypertension when transitioning out of menopause, known as postmenopause.
There are several factors that play a role in raising high blood pressure risk during perimenopause and postmenopause, including a decrease in levels of the hormone estrogen. This can lead to stiffening of the arteries and increase the body’s sensitivity to salt.
On the flipside, past research shows that premenopausal women usually have a lower high blood pressure risk than perimenopausal or postmenopausal women, partly because they have higher levels of estrogen in their bodies.
Now a new study published in the journal Mathematical Biosciences helps to explain just how estrogen may help protect against hypertension.
For this study, researchers developed a mathematical model of women’s cardiovascular and kidney systems. The model was used to incorporate the effects of estrogen on the body’s
Through their model, scientists discovered that estrogen’s ability to relax and widen blood vessels, known as vasodilation, may be the key factor behind its ability to help lower blood pressure.
Researchers also used their model to predict how two common anti-hypertensive drugs might work with estrogen.
They found that angiotensin receptor blockers (ARBs) may be more effective than angiotensin converting enzyme (ACE) inhibitors in treating high blood pressure in women, even after their estrogen levels have declined postmenopause.
“Estrogen is often thought of only in terms of reproductive health, but it plays a much broader role in how the body functions,” said Anita Layton, PhD, the Canada 150 Research Chair Laureate in Mathematical Biology and Medicine and professor of applied mathematics, computer science, pharmacy, and biology at the University of Waterloo, and lead author of this study, in a press release.
“It affects how blood vessels respond, how the kidneys regulate fluids, and how different systems communicate with one another. What we found is that its impact on blood vessels is especially important for regulating blood pressure,” Layton explained.
“For too long, women’s health, especially older women’s health, has been overlooked by medicine,” she added. “Understanding how age and sex affect the body and, therefore, treatment, is an equity issue.”
Medical News Today had the opportunity to speak with Prudence Hall, MD, an OB/GYN in private practice in Santa Monica, CA, about this study.
Hall, who was not involved in the research, commented that her first reaction to its findings was relief that once again, a study has addressed the issue of
“Menopausal increases in blood pressure contributes tremendously to morbidity and mortality in menopausal women, with cardiovascular disease being the
“We simply have to address menopausal hormonal deficiencies and replace those missing hormones with transdermal estradiol, which is bioidentical to every woman’s estrogen,” she suggested.
MNT also spoke with G. Thomas Ruiz, MD, a board-certified OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, likewise not involved in this research.
Ruiz commented that this is yet another one of the published studies over the past 2 to 3 years that suggest there may be significant benefits when it comes to estrogen therapy for menopause.
“Researchers need to continue to look at the various organs within a woman’s body that have estrogen receptors to understand estrogen’s positive effects,” Ruiz explained. “As long as a menopausal woman takes estrogen, those receptors will function,“ he theorized.
According to Ruiz: “If a postmenopausal woman is not taking estrogen, eventually those estrogen receptors will be downregulated and become nonfunctional. Some research on how hormone replacement therapy affects a woman’s metabolism and metabolic rate would be useful.”
The key question, he said, is: “Everyone’s metabolism slows with aging but if a woman is on hormone replacement therapy, what is the rate of metabolism slowing as compared to a woman not taking hormone replacement therapy?”
For more insight into the cardiovascular impact examined by study, MNT spoke to Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA.
“This mathematical model suggests that estrogen contributes to cardiovascular health by helping to relax blood vessels, thereby improving blood pressure,” Chen, who was also not involved in this study, said. “These results add to our continuously evolving understanding of how estrogen affects our heart health.”
“High blood pressure is a significant risk factor for developing heart disease,” he continued. “As postmenopausal women are at higher risk for heart disease, controlling blood pressure in this population is important to help improve their heart health. Future research will be necessary to validate these findings in a biological model.”
