Are you still experiencing hot flushes, even in post-menopause?
What can I do to reduce my risk of heart disease as I go through menopause?
This is a question often asked by women in menopause and post-menopause who join me on the Beyond Menopause™ program and discover that, despite being on HRT, their blood pressure is elevated.
There are a number of reasons for this, but the most important reason, is that the heart and blood vessels are ageing and changing as women transition from menopause to post-menopause.
In 2010, leading cardiologists from five European countries attended a seminar in Belgium which resulted in an article published a year later called, ‘Red Alert for Women’s Heart: The Urgent Need for More Research and Knowledge on Cardiovascular Disease in Women.’ (Maas, van der Schouw et al., 2011).
One of the main points the article made was that, despite significant differences between men and women in the presentation of most cardiovascular diseases, midlife and older women were still inadequately represented in research on heart disease.
A decade on, according to one of the lead authors, world-renowned Cardiologist from the Netherlands, Dr Angela Maas, some gains have been made, but not enough.
One of these gains has been the understanding that the female heart as it ages, undergoes considerable change when oestrogen and progesterone decline during menopause. So too, do the blood vessels as they lose some of their elasticity and become ‘stiffer’.
Hence, menopause really does matter to women’s cardiovascular health as they move into their post-menopause years.
How we transition through menopause especially matters to the changing nature of our blood pressure. And for those of you who are still experiencing hot flushes/ flashes despite being on HRT and you are in post-menopause, then don’t blame the menopause – because it’s not. Afterall, you are through menopause.
It’s the natural ageing of your heart muscle, nerves and vascular system (blood vessels).
Hence, I wonder, if you are also getting your blood pressure checked? If it’s reading higher than normal, then you aren’t alone.
Your midlife heart health offers a critical window for implementing early intervention strategies to reduce cardiovascular risk, this includes understanding how to have the right nutrients for your heart health as you age.
Why we aren’t recognising cardiac health more in lifestyle solutions during menopause had me perplexed. At the time that my own menopause symptoms were troubling me, I had no idea that I should be changing my diet and exercising in ways that benefit my cardiac health in my 50s.
As you can see from the image below, hypertension can occur across a women’s lifecycle (Wenger et al, 2018). I’ve added in many of the potential causes for women in menopause and post-menopause.
What causes your blood pressure to increase (hypertension) during menopause?
Menopause isn’t ‘just’ about hot flushes – it’s about your changing blood pressure too.
What makes your blood pressure increase during menopause? Do you know? Yes, stress contributes to hypertension, but so too does lack of sleep as well as the decline in some of the elasticity in blood vessels – a condition called vascular stiffness.
The term ‘hypertension’ means high blood pressure.
High blood pressure develops when blood flows through your arteries at higher-than-normal pressures. Whilst it’s absolutely normal for your blood pressure to change throughout the day based on your activities, lifestyle and dietary patterns, there are specific risk factors that are unique to women in menopause that are separate from genetic risk factors.
These factors include,
- history of smoking
- underlying kidney disease
- being overweight or obese
- high LDL cholesterol and low HDL cholesterol
- high or low iron levels (especially high iron in post-menopause)
- low Vitamin D levels
- living a sedentary lifestyle (or doing too much exercise)
- changes to reproductive hormones which impact blood vessel elasticity
- sleep disturbance
- increased hot flushes
- high alcohol consumption
- liver inflammation
- medications
Have you had your blood pressure checked recently?
If so, then you might like to check it against the new American Heart Association Guidelines (AHA, 2020). The two different numbers are the systolic (top number) and diastolic (bottom number.
The Systolic pressure is the pressure when the ventricles pump blood out of the heart. The Diastolic pressure is the pressure between heartbeats when the heart is filling with blood.
For most women, a normal blood pressure is less than 120 over 80 millimeters of mercury, which is written as your systolic pressure reading over your diastolic pressure reading—120/80 mm Hg.
Your blood pressure is considered high when you have consistent systolic readings of 130 mm Hg or higher or diastolic readings of 80 mm Hg or higher.
Poor sleep causes high blood pressure during menopause
Your blood pressure increases gradually over time. If you are in your menopause transition and you aren’t sleeping, then you may be losing your ability to lower your blood pressure overnight. This disappearance of a nightly dip in blood pressure can be a sign of rising blood pressure.
Specifically for women in menopause experiencing night sweats and/or hot flushes on waking, this is related to blood pressure remaining elevated overnight.
The reason is that one of the chronic stress hormones called cortisol, remains elevated too.
That’s why, as I mention in the 12 week MyMT™ programmes, it is essential that women re-train their brain to sleep all night again.
Not sleeping during your menopause transition is the slippery slope towards heart disease in post-menopause.
And if you are in post-menopause and still having hot flushes, then don’t blame menopause – you are through menopause – blame your changing blood vessels and heart muscle, both of which lose elasticity and become ‘stiffer’, as you age. I talk about this in my online Masterclass on Menopause webinar too. At only NZ$15 (approx. AU$14, UK£8, €9, US$9, CAD$12) you can’t afford to miss this 2 part webinar!
Understanding the Circadian Cycle of your Blood Pressure
Like many of your organs and bodily functions, your blood pressure varies, not only within a 24 hr circadian (day/night) cycle, but also throughout the seasons.
Based on your 24 hour circadian cycle, it tends to be lower in the morning and higher towards dinner time. If you’ve been experiencing worsening hot flushes/ flashes in the evening, then this is why!
But there is also a seasonal influence – during the colder months it tends to be higher than in the warmer months.
Which makes sense, because when we are warmer, the blood vessels dilate more to take heat towards the surface of the skin. When blood vessels are wider, then blood pressure is reduced.
During colder weather, blood vessels become more constricted as the body tries to hold onto heat, so blood pressure is increased to maintain your body temperature.
Do you have any symptoms of high blood pressure? These include worsening hot flushes, feelings of dizziness, migraines and headaches, blurred vision, anxiety and insomnia.
It took me a while to work out that there was a correlation between my menopause symptoms, especially hot flushes and decreased energy levels and my increased blood pressure and cholesterol, as I moved into post-menopause.
If you’ve got any of the symptoms I’ve mentioned and you think that they are related to your changes during menopause, then yes they are! Transitioning through menopause changes your blood pressure, so please get it checked when you can.
Are there specific dietary changes I should make for heart health?
One of the most challenging things to do as we age, is to change how we look after ourselves. And according to the thousands of women on the MyMT™ programmes, we also need to learn to put our health at the forefront of our focus.
There are four main evidenced lifestyle strategies that I focus on with women who join me on the MyMT™ programmes. These include:
- Restoring sleep patterns to better reflect our circadian cycle.
- Reducing inflammation in the liver, gut and blood vessels which also contributes to hypertension.
- Reducing stress.
- Restoring energy levels through a modified Mediterranean Dietary approach.
For example, it is well known that daily walking improves blood pressure in women, but so too does an increased intake of citrus fruits, which gives women more Vitamin C. This vital vitamin is crucial for reducing hypertension as women age.
Studies on women (aged 35 to 77 yrs) living in Hiroshima Province in Japan, showed that over a 5 month period of ingesting lemon juice daily as well as walking for a minimum of 30 minutes daily, reduced systolic blood pressure (the top number) significantly.
Whilst it’s known that aerobic exercise helps to improve the vascular stiffness reported in post-menopausal women (Tanaka, 2020), it is less well known that Citrus fruits such as lemons, contain bioactive compounds such as citric acid, that promote absorption of calcium and magnesium in the small intestine.
Both these minerals are essential for heart and blood vessel function as we age.
What Nutrients are needed for heart health during and after menopause?
You will always find apples and tomatoes in my kitchen, especially as I’ve moved into post-menopause.
Tomatoes are rich in lycopene, and this powerful bioactive ingredient is good for your ageing heart. If you can’t tolerate cooked tomatoes, then lycopene is also found in pink guava, papaya, pink grapefruit, and watermelon.
Lycopene is a potent antioxidant that fights oxidative stress in your blood vessels, reducing blood pressure and lowering your cholesterol levels [Bin-Jumah et al, 2022].
Apples are also an important contributor to the intake of dietary components linked with cardiovascular disease (CVD) prevention.
An apple a day really may keep the Doctor away, because apples, especially the red skin of apples, contain Quercetin – a compound that is found in numerous menopause supplements.
Quercetin is a polyphenol derived from plants, but is particularly concentrated in the skin of apples. I try and buy organic apples for this reason. Not only is Quercetin evidenced for brain health in older women, but it has a wide range of biological actions including anti-carcinogenic, anti-inflammatory and antiviral activities as well as helping to reduce clotting in arteries that are changing with age. (Yao Li et al., 2016).
Apples not only contain quercetin, but are high in Vitamin C and fibre and therefore, have beneficial effects on blood vessel function, blood pressure, lipids (blood fats), inflammation and hyperglycaemia (high blood sugar). [Bondonno et al, 2017].
If you aren’t having an apple a day during and after menopause, then perhaps you should!
Re-discover your health, vitality and energy during and after menopause with evidenced lifestyle-change programmes designed by Dr Wendy Sweet (PhD)
You will love what you learn on the online 12 week MyMT™ programmes. Circuit Breaker is for you if you are thinner or leaner. Transform Me is for you if you are overweight. Or start with the Masterclass on Menopause webinar HERE.
Not only will you learn how to adjust your lifestyle to better suit your menopause transition, but also how to manage your cardiac health with lifestyle solutions, restore your joint and gut health and if you need to, lose weight and manage hot flushes and more! And yes, I will motivate you to become more active too. It’s good for your heart!
Start with the MyMT™ Masterclass on Menopause Webinar
Can I help you with your symptoms and/or your menopause weight loss?
If you are struggling with your mid-life weight, health or symptoms, then come on board if you can into my 12 week online programmes. MyMT™ 12 week programs are normally available for NZ$399 each, but please do check out the MyMT™ website or subscribe to our newsletter to be alerted to any promotional offers.
Or as a starting point, you can purchase my online Masterclass on Menopause. This is only NZ$15 (approx. AUS$14, US$9 or UK£7.5).
I hope you can join me in this powerful 2 hour webinar, which is all updated and revised and is now in two parts. The great news is that now you can watch it anytime, anywhere and even pause it whenever you like and go and make yourself a cup of tea too.
References:
Australian Institute of Health and Welfare (2019). Cardiovascular disease in women. Cat. no. CDK 15. Canberra: AIHW.
Bondonno, N. P., Bondonno, C. P., Ward, N. C., Hodgson, J. M., & Croft, K. D. (2017). The cardiovascular health benefits of apples: Whole fruit vs. isolated compounds. Trends in Food Science and Technology, 69(B), 243-256. https://doi.org/10.1016/j.tifs.2017.04.012
Bin-Jumah, M.N.; Nadeem, M.S.; Gilani, S.J.; Mubeen, B.; Ullah, I.; Alzarea, S.I.; Ghoneim, M.M.; Alshehri, S.; Al-Abbasi, F.A.; Kazmi, I. Lycopene: A Natural Arsenal in the War against Oxidative Stress and Cardiovascular Diseases. Antioxidants 2022, 11, 232. https://doi.org/10.3390/antiox11020232
Bowen, K.J., Sullivan, V.K., Kris-Etherton, P.M. et al. Nutrition and Cardiovascular Disease—an Update. Curr Atheroscler Rep 20, 8 (2018).
De Pergola G, D’Alessandro A. Influence of Mediterranean Diet on Blood Pressure. Nutrients. 2018 Nov 7;10(11):1700.
Gordon, A. & Mendes, W. (2021). A large-scale study of stress, emotions, and blood pressure in daily life using a digital platform. PNAS, 118 (31) e2105573118.
Kato, Y., Domoto, T., Hiramitsu, M., Katagiri, T., Sato, K., Miyake, Y., Aoi, S., Ishihara, K., Ikeda, H., Umei, N., Takigawa, A., & Harada, T. (2014). Effect on blood pressure of daily lemon ingestion and walking. Journal of nutrition and metabolism, 2014, 912684. https://doi.org/10.1155/2014/912684
Khoudary, S., Aggarwai, B., Beckie, T., et al (2020). Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation, 142: e506–e532
Li Y, Yao J, Han C, Yang J, Chaudhry MT, Wang S, Liu H, Yin Y. Quercetin, Inflammation and Immunity. Nutrients. 2016 Mar., 15;8(3):167. doi: 10.3390/nu8030167. PMID: 26999194;
Wenger, N., Arnold, A., Bairey, N. et al ( 2018). Hypertension across a woman’s life cycle. Journal of the American College of Cardiology, 71(16), 1797-1813
Related Tag: Menopause Treatment New Zealand
