High blood pressure & GP advised I stop HRT suddenly - is this a good idea?

[bloominoreilly]

I had my annual HRT review today. I'm on 3 pumps of oestrogel daily & have Mirena IUD + I have vag pessary twice weekly. I had high blood pressure reading at the GP today so I'm going to take readings twice a day for a week then go back to see GP next Friday. She told me to just stop taking HRT now, but I'm worried about that - won't that be like falling off a cliff, aren't you supposed to taper? I've been on HRT since April 2022. Can anyone advise whether it's best to taper? I'm wondering if I should seek advice from a menopause expert - can anyone recommend any? Thanks!

My readings have been similar the past few months giving me headaches. My GP has said HRT helps lower BP so no chance she’ll be stopping it. She’s added a beta blocker and the numbers look ok now.

peri menopause can cause spikes in BP and I’ve now spoken to several women in this boat. Medication is needed but no need to stop HRT.

I've never heard of feet flat on the floor to take BP but if you're sitting at a table with your arm rested at the same level as your heart, your feet should be on the floor anyway.

In an ordinary chair, yes (although often then you don't have the correct back support). But in hospital triage, or if you see the nurse in your GP surgery rather than the GP, you often have it taken in a phlebotomy chair. These have the correct back support and arm position but they are often very high. They should have an adjusted foot rest for a correct reading, but many don't - or it's not used.

The advice on avoiding isometric exercise if you have high blood pressure is outdated. It's now been shown to be much better at lowering pressure than aerobic exercise, HIIT, or dynamic resistance training. You just have to be careful to not hold your breath while doing it. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/isometric-exercise-and-blood-pressure

And of course like any new exercise, start small and work up.

Out of interest where is the info about back support? And what difference does it make?

A couple of family members have to take BP at home, regularly, and have never been advised about back support or had it done that way in a medical setting.

I had to stop suddenly a couple of years ago, for about 6 weeks. I didn’t enjoy it at all but I was fine health wise.

Glad others are advising you on the BP aspects of it, I appreciate that’s a factor that needs careful handling.

I think it was someone on the Zoe podcast that I first heard mention back support, but this has the full checklist: https://www.bloodpressureuk.org/your-blood-pressure/how-to-lower-your-blood-pressure/monitoring-your-blood-pressure-at-home/how-to-measure-your-blood-pressure-at-home/

I've done some tests with my home monitor, and sitting forward instead of using the backrest gives a small rise.

That isn’t really that high especially after the coffees and no breakfast.

Not sure about the link between the blood pressure and HRT but I had to stop my HRT suddenly for health reasons and have been amazed how good I feel as I was expecting all my symptoms to return but so far so good . ( Stopped 4 weeks ago). So if you find you do have to stop suddenly it may be ok

What a hassle! Glad you got it sorted in the end. It's good to know what to expect, to sone extent, so thank you

That's good to hear!!

Thanks, everyone, you've been a great help. I kinda feel like I know what I'm doing now!

Obviously your blood pressure needs addressing.

However abrupt estrogen withdrawal would in all likelihood only destabilise things further.

I would ask your GP if she would refer a younger woman with hypertension for an urgent bilateral oophorectomy.

Hopefully this will prompt a reconsideration of the medical appropriateness of her suggestion.

This is such bad advice OP. At the very least they should lend you a BP machine and take readings twice a day at home for a fortnight.
Mine is always high at the GP and normal at home.

Evidence shows that HRT is better than statins & BP meds in reducing cardiac disease/ events, so I'd be very reluctant to stop your HRT.

Take a look at the Balance Menopause website, there is lots of informative & guidance on there.

You don't have to beg your GP practice for a BP machine. They aren't that expensive to buy, you can get a reliable model from most pharmacies or Amazon, and as others have said, take your own readings at home over a couple of weeks without any stress or being rushed etc.

Often the "high blood pressure" that you had at the GP surgery is not a truly representative reading, particularly where you are made to feel like your access to a much needed treatment is contingent on getting a certain BP reading in your appointment.

Every time I went for my pill my usually low blood pressure would be artificially ramped up by nerves in the appointment.

I get my pill from an online provider now so monitoring my blood pressure is completely uncoupled from make-or-break access to treatment in a single reading taken under stress, and problem solved.

Best thing for a reliable picture of your BP is to get a wearable monitor. This is what I did after a very high reading in medical setting and it turns out I’m fine but it does go higher in the small hours so I need to get that investigated.

But that wouldn’t have shown
up with me taking it twice a day.

I’ve managed to reduce my BP overall with diet and exercise in under 4 weeks. I wasn’t overweight but I do have a family history so I need to be at the lower end of ideal weight.
if I have to take pills I will but want to try lifestyle adjustments first.

Thanks - the GP asked if I have one at home & I do. I am doing a twice-a-day diary for a week. My BP has defo become high according to these readings but I decided to stay on the HRT but make a few lifestyle changes.

Thanks 😊

Thanks - good tip about the pill, I'll bear that in mind if I do go on meds

The wearable sounds like a great idea, and thanks for sharing your circumstances, they're very encouragjng. I'm similar to you - not overweight, gave up drinking over a year ago, never smoked, didn't add salt to things, but got family history. Since last Friday I gave up coffee & have eaten very, very healthily & calmed myself down - it's been an eye opener, I've realised just how agitated & sped up I always was! Fear of a sudden stroke has really made me pull back and be calmer about everything I do. Tonight I had my first pre-high blood pressure reading of the week (yay!) - so I'm hoping by the time I see GP again on Fri I'll have more & I won't need to go on meds. Thinking of getting a wearable - can you recommend one?

Thanks - I'd forgotten all about the Balance app so I'll have a look!

How many readings did Dr take? Hopefully at least 2 or 3. Certainly two caffeinated coffees would not be helpful for your blood pressure reading.

https://shop.bhf.org.uk/health-fitness/health-monitoring/blood-pressure-monitors?_gl=11bzt7ct_gcl_auMTg4Mjg0MDg2LjE3ODE5MzgyNjU.FPAUMTg4Mjg0MDg2LjE3ODE5MzgyNjU._gaNTc3NzcxMDEuMTc4MTkzODI2NQ.._ga_L1TRS9RE0M*czE3ODIyNTIxMzMkbzIkZzAkdDE3ODIyNTIxMzQkajU5JGwwJGgw#buyingguide

Found this! (In case anyone else is interested)

Well done for getting the reading down. It moves surprisingly quickly once you take action.
i agree re the calming down. I’m inclined towards impatience if I don’t watch ,myself, and it’s rarely warranted, and never useful!
so I got one called Hilo, it seems to be ok, although there may be better ones. I got it through my NHS app, there was a link to a site and I got it from there. It was £200 and includes a cuff to calibrate (you’re sposed to do this once a month th) with the wrist band. The wrist band looks like a bit of 80’s goth accessory to me ;-) but as I wear black it suits me. I think you could probably use anything as a wrist band though as long as it fits through the lugs.

There is no way a single reading taken at the GP's should be considered as accurate! I'd look at other factors before immediately blaming it on HRT, which you are already doing OP.

I wouldn't bother cutting down on your HRT dose either as I suspect all that will happen is you'll get a return of symptoms without it affecting your BP.