Stress, Menopause Can Raise Blood Pressure

Q:  I am 55 years old and up until now I've been in good health, except a little problem with hot flashes from menopause. I do not take estrogen.

The question I have regards sudden high blood pressure. Until recently my blood pressure has remained a constant 120/80 for 25 years. Even with family deaths and other problems, it stayed normal. I manage an 8-family apartment complex and have been under lots of stress for several months.

I had a nurse take my blood pressure and it was 150/90. Two hours later it was 190/95, and today I went back to see her and it was 170/90. This sudden increase is scary to me as I live alone. I feel fine, but now I am anxious. My question is could this rise in blood pressure be due to so much stress, or does menopause play a part also?

A:  To make the diagnosis of hypertension, elevated measurements greater than 140 systolic (the top number) or 90 diastolic (the bottom number) on three separate occasions are required. Technically you need one more reading to confirm the diagnosis, since the first two readings were on the same day.

There is no question that stress can contribute to high blood pressure, but it really doesn't matter what the cause is. Sustained high blood pressure puts you at risk for stroke and heart attack. Women often gain 5-10 pounds at menopause, which may also increase blood pressure.

When women have hot flashes, the finger skin temperature rises about 7.5 degrees F and the pulse rate may increase an average of 9 beats per minute for the duration of the hot flash (usually about 3 minutes). Blood pressure, however, usually remains constant.

Although both the stress you've been under and also menopause may be partially responsible for the increased blood pressure, I recommend that you be seen by your physician soon to look at the whole picture.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.