Estrogen and Blood Pressure

During menopause, women lose hormone protection against a wide array of fatal medical conditions. Among them is high blood pressure or hypertension, which is highly prevalent in menopausal women. In addition to this, the age-related decline in estrogen levels puts them more at risk since estrogen engages several mechanisms that protect against hypertension. An overwhelming body of clinical trials supports the antihypertensive effect of estrogen:
1. Transdermal delivery of estrogen appears to have blood pressure-lowering effect in postmenopausal women and may be a safer alternative in hypertensive women. [441]
2. In postmenopausal women with arterial hypertension, one-year ERT improves circadian blood pressure pattern by inhibiting age-related rigidity of large arteries. [442]
3. In women with elevated resting blood pressure and positive family history of congestive heart failure (CHD), ERT inhibits exaggerated BP reactivity to stress. [443]
4. In postmenopausal women, transdermal ERT improves 24-hour blood pressure profile. [444]
5. In hypertensive postmenopausal women, ERT is associated with a lower diastolic blood pressure and decrease use of antihypertensive drugs. [445]
6. In menopausal women with mild to moderate hypertension, ERT use is associated with lower blood pressure. [446]
7. In postmenopausal women, ERT use is associated with lower pulse wave velocity (PWV), a measure of arterial stiffness. [447-450]
8. ERT improves blood pressure by counteracting arterial distensibility and increasing nitric oxide levels which both lead to widening of blood vessels. [451-456]