HRT and high blood pressure

[chocolatesaltyballs22]

Hi all,

Keen to get some advice from all of you menopause experts. Have been on HRT for about 15 months, increased dose 3 months ago (on Kliofem). Just been to see the doctor for a review and my BP is higher than it should be. She wants to see me back in 4 weeks but said if it's still high she will have to take me off HRT. My obvious reaction to this was obviously NOOOOOOOOOOOO as it's the only thing that's made me feel human again! Surely there are other things they can try which are lower risk for high BP such as the HRT gel or patches? Has anyone else had any experience of this? Am filled with horror at the idea of having my lifeline removed.

You GP is a bit out of touch.

The guidelines for HRT and high BP are...

treat the high BP with meds and/ or lifestyle/ diet measures but do not stop HRT (unless through the roof and other risk factors for stroke.)

Have you been advised on how to get your BP down by diet and exercise? There is a national BP charity/ organisation which has a helpful website.

Might be something like BloodPressure.uk

You do need changing to a patch or estrogen gel as neither of these have any bearing on BP.

Hmmmm...this was based on one reading as well, and was only slightly over what it should have been. We will see what she says when I go back and what my BP is then, I just felt like it was a bit of a knee-jerk reaction but thanks for that advice. I honestly don't think I have high BP, I think this is a one-off reading. I was a bit stressed this morning!

I can't have hrt due to being on bp tablets. My readings are fine but still no hrt.
Amitriptilyne has been my savour though.

@chocolatesaltyballs22 Buy your own BP monitor for around £20 and test at home. No one is diagnosed with high BP after one reading in the drs- everyone knows it's white coat syndrome (except your dr it seems.)

@AngusThermopyle You should see a different GP. The guidance for GPs is clear- treat high BP with meds and once settled to norm, give hrt. what is Ami helping with?

@JinglingHellsBells
Insomnia and anxiety. I've never felt better. My gp is actually Fantastic. I also cannot have hrt for other reasons (that I don't wish to post here)

So what she said was she'll take BP again in 4 weeks. If it's still high, I'll have to wear a 24hr monitor (woohoo - I can't sleep as it is so I'll have no chance with the thing squeezing my arm every hour) and then she will take the average to determine whether my BP is high. So we're a way off from the threat of stopping HRT but it still fills me with dread. Based on what you've said though, I'll be challenging this if it comes to it.

I also have amitriptyline for nights when I haven't slept properly in a while and I really need to, but I'm finding that 10mg isn't doing much for me any more.

You could still get a home monitor as suggested by Jingling. I did that and went back armed with 4 pages of readings and my GP found it very useful. (Although I don't recommend amazon ones as I had two that gave false readings so got a pharmacist recommended one)

I took my amitriptylene intermittently at first but that didn't work, so GP suggested I take it every night regardless. 100% improvement now.

@AngusThermopyle You have to appreciate that Ami is not first line treatment for menopause. It's for women who cannot take HRT because they have usually had one of the serious illnesses like cancer, stroke or recent heart attack. There are in fact very few reasons why HRT can't be used (and GPs are often unaware and under-prescribe.)

NICE guidance is very clear on this and advises GPs NOT to offer ADs.

Ami is an anti anxiety drug and yes, it causes sleepiness (as well as other side effects.)
It's also used as a pain killer taken at low doses.

But it won't help with bone health, prevent heart disease, pelvic floor atrophy or lots of other things women experience post meno, so it's not suitable for women who can use hrt.

Yes I've been on HRT for 9 years. I had high bp so I went on bp meds to bring it down.

It actually went too low so I've come off them now but I wasn't asked to come off the hrt.

Thanks everyone this is useful. I'm now armed with info when I go back to the GP.

@AngusThermopyle what dose of amitriptyline do you take?

I’m on BP meds AND HRT - well Qlaira - it’s actually a contraceptive but with the oestrogen (I think too)

My doc definitely treated the high BP first (before modifying the failing HRT meds I was on at the time) as soon as the BP was controlled it gave us the opportunity to fix everything else.

See if you can see a different doc?

BP MEDS are ramipril if that helps?

I can't have HRT because of my blood pressure. I have hereditary high BP and despite the BP meds, HRT introduced into the mix just made everything very much worse. I could have stroked out at any moment. So I am just getting on with it.

I do live in hope that the menopause is perhaps on the way out. I have had 3 occasions when the hot flushes have stopped completely. The first two times was for a month each time. This last time was for 10 weeks, and I really was getting my hopes up that it was over! Sadly, they are back along with the night sweats and the bloody awful spots on my chin, but fingers crossed...

@chocolatesaltyballs22

just a thought - but what height/weight are you? My BP came down quite a bit when I lost a couple of stone. I'm 'enjoying' the menopause as we speak without HRT.

It's really bad that so many women ar being denied HRT because of high BP.
Estrogen actually makes the arteries more flexible and there is loads of research (I write health features by the way for the media which is why I have this info to hand!) showing that HRT benefits circulation and prevents plaque building up in the arteries.

The advice is for women with high BP to treat it with drugs and lifestyle measures, and give transdermal HRT not tablets.

@LittleCandle were you using tablets or patches?

@chocolatesaltyballs22
I am on 10mg.

@JinglingHellsBells
I appreciate what you are saying but you don't know anything about my health or my history or any other medication. My GP is actually a very knowledgeable woman about hrt and other womens health issues. So please stop with your armchair diagnosis of my condition. Thanks.

@AngusThermopyle Of course I know nothing about your condition. But you don't have high BP and so you have sort of hijacked the thread as having another condition that stops you using HRT and the other options for insomnia is not what the OP asked about.

This is a thread about HRT and high BP. My posts are for any women reading this. I am quoting medical guidelines as in Nice 2015 Menopause Guidance and the BMS guidance.

Yes, op, I apologise for "sort of hijacking the thread" after replying to a poster tagging me three times.

I hope you get your situation sorted eventually, hopefully, you find some good qualified healthcare professionals.
My advice still stands re the sleeping issue so it's worth asking about.

@Rachel438 I'm 5 ft 2 and a size 14, have been for years. I go to the gym 5 times a week. Yes, I'm a bit overweight but not massively so, and I truly don't believe that I have high BP from one reading. I think it's white coat syndrome.

Well everybody's making valid points, I think.

I'm on HRT patches, OP, and I have high BP. I have done ever since pregnancies (DC now in early 20s!). I agreed with my GP to take medication, buy an Omron BP monitor, and monitor myself conscientiously.

I reached this agreement with the GP after quoting the latest NICE guidelines to him, courtesy of Jingling and I'm grateful for that steer from her.

I've got a bumpy medical history including a DVT so I've had my work cut out getting HRT, but it's been incredibly helpful for me, especially as I've had my ovaries removed. I'd not have managed without it.

Arguably the important thing is to show that you understand the (very small) risks, and are happy to proceed, as with all medical treatment.

OP, thinking about white coat syndrome - I always read my own BP x3 times before I go to my GP surgery and write it down for them, because I just know I'll get a mega-high reading there! (Because I'm stressed and I've just walked the mile there or driven through horrendous traffic.)

Yeah I think I need to invest in a monitor.

@JinglingHellsBells - I was on tablets as I cannot use patches due to being allergic to the adhesives that they use. Because there is nothing particularly wrong with my heart, no high cholesterol etc, just a genetic tendency to HBP, I was advised not to continue with the HRT and I have been happy to follow that advice.

@littlecandle Just replying to your comment for me....information for all women reading....who have high BP issues...

The most popular option for HRT now and one used by female meno consultants themselves is Estrogen gel with Utrogestan as the progesterone. It is transdermal and not a sticky patch.