Pregnancy, High Blood Pressure and Menopause

Hypertensive pregnancies possibly associated with menopausal cold sweats and hot flashes

(RxWiki News) High blood pressure and menopause can both put women at potential risk for heart disease. It's possible that having high blood pressure while pregnant can affect the severity of menopause.

A recent study examined the connection between a history of hypertensive pregnancy diseases (high blood pressure or diabetes during pregnancy) and vasomotor menopausal symptoms (hot flashes or night sweats due to sudden opening and closing of the blood vessels near the skin).

The researchers found that the women with a history of hypertensive pregnancy disease (HPD) were more likely to have vasomotor menopausal symptoms (VMS), experience them for a longer time period, and have more severe VMS compared to the women that did not have a history of HPD. The findings showed that the frequency and intensity of VMS did not differ between the two groups.

The researchers concluded that these findings are only moderately significant and more research is needed.

"Talk to your doctor if you have a history of hypertension in pregnancy."

The lead author of this study was José T. Drost, MD, from the Department of Cardiology at Isala Klinieken in Zwolle, the Netherlands.

The participant group was made up of 853 women who visited a weekly outpatient cardiology clinic for women in the Netherlands between 2003 and 2010. All the participants were between the ages of 40 and 70 at initial consultation.

The researchers gave the participants a questionnaire asking them to self-report any previous pregnancies, history of HPD, demographic information (i.e., race, economic status), physical complaints, lifestyle risk factors (i.e., smoking, lack of physical activity, alcohol consumption), history of medication use, cardiovascular history, family cardiovascular history, and obstetric history.

A participant was classified as having hypertension (high blood pressure) if her systolic (force of blood in arteries as the heart beats) blood pressure was 140 mmHg or higher, if her diastolic (force of blood in the arteries as the heart relaxes between beats) was 90 mmHg or higher, or if she took antihypertensive medication.

The researchers then assessed the presence, duration, frequency and severity of VMS using another questionnaire.

Duration was measured by how long a participant experienced VMS, with options ranging from six months to over 20 years. Severity was measured by how much the symptoms interrupted a participants' daily life.

Frequency was measured by how many times per week a participant experienced symptoms. Intensity was measured by combining the measurements of frequency and severity.

The researchers found that the average age of the whole participant group was 55.5 years. Out of the 853 women, 274 (32 percent) reported a history of HPD.

The findings also showed that the women with a history of HPD weighed more, had larger waist sizes, and higher blood pressures than the women without a history of HPD. The women with a history of HPD were also found to be more likely to have had a history of diabetes during pregnancy, be postmenopausal, and have hypertension (high blood pressure.)

The researchers discovered that 83 percent of the women with previous HPD reported presence of VMS compared to 75 percent of the women without. In both of the groups, 73 percent reported experiencing both night sweats and hot flashes.

In both groups, the researchers found that 48 years was the average age of first symptom experience.

The researchers also found that the women with a history of HPD had a 73 percent increased risk of experiencing VMS compared to the women with no history of HPD. The researchers then factored in potential outside factors and found that the HPD group was 62 percent more likely to experience VMS than the non-HPD group.

The researchers determined that the frequency and intensity of VMS did not differ between the two groups.

Overall, the researchers found that associations between HPD and VMS were not extremely strong and believe that more research needs to be done.

"This study is interesting because it shows a potential relationship between hypertensive disorders of pregnancy and vasomotor symptoms of menopause. What that relationship is remains undetermined. Knowing this does not change anything about how we are currently treating our patients, but it is certainly a part of reproductive medicine that needs further exploration," said Sarah Wagner, MD, obstetrician and gynecologist at Loyola University Health System and assistant professor at Loyola University Chicago Stritch School of Medicine.

"All patients, but certainly those who have experienced hypertensive disorders of pregnancy, should make sure to practice the healthiest lifestyle that they can. Your physician can help you to do that," said Dr. Wagner, who was not involved in this study.

The authors noted a few limitations of their study.

First, histories of HPD and VMS were self-reported. Second, the researchers did not have any information on the severity of HPD and other issues. Third, menopause status was based on whether or not a participant still menstruated, which can be determined by a woman's self-reported personal life.

This study was published in the October edition of Menopause.

Review Date: 
October 5, 2013