HRT and blood pressure

[bridgetreilly]

I’ve been on HRT for just over three months and it has been amazing. Brain fog, memory problems as well as some physical symptoms all disappeared.

This morning I went to the GP for the medication review. I have been struggling with my depression and needed an increased dose for my citalopram. GP measured my blood pressure - which is pretty high - and told me I must immediately stop the HRT. I am on patches.

Everything I can find online says this is out of date advice and that the patches can actually help to lower blood pressure, and that there is no evidence at all to suggest that they might make it worse. I really, really, really don’t want to come off the HRT.

What would you do?

Blood Pressure UK

Guys and Thomas’s NHS

“Can you take HRT if you have high BP?

For most women, it’s perfectly safe to take HRT if you have high blood pressure or you’re taking medicines to lower your blood pressure. Your doctor will simply need to keep an eye on your blood pressure and adjust your medicines if needed.

There is a lot of confusion around HRT and blood pressure and some women have been needlessly advised against HRT. However, a review of the evidence showed that postmenopausal women with normal and high blood pressure had a very low risk of a rise in blood pressure with all forms of HRT, and in fact their blood pressure was often lowered.

Estrogen taken as a tablet has the potential to raise blood pressure but taking estrogen through the skin as a patch, gel or spray allows your blood vessels to widen – so it can lower your blood pressure rather than raise it. Progestogens have different effects and while some could raise blood pressure, the newer type, called micronised progesterone, appears to have no effect or even lowers blood pressure. Women with raised blood pressure can still usually take HRT and it is safe to take blood pressure lowering medication with HRT.”

https://www.balance-menopause.com/menopause-library/high-blood-pressure-factsheet/

As far as I know, HRT is ok if your BP is controlled and it doesn't sound like yours is at the moment. I expect the GP wants to see what your BP is like without it and then they can decide on a course of action.

According to my GP, BP can be managed with anti hypertensives alongside HRT.

What she actually said was that there is a strong contra-indication for HRT if you have high BP, not that they want to check to get it under control. I am very happy to go on BP meds if necessary. I really don’t want to stop the HRT to do it!

What did she say the next step would be?

I have high BP anyway and I'm on HRT with no issues. I don't understand why it would be contra-indicated? It makes no sense. Surely your GP should look at other factors before withdrawing HRT? Have you checked your BP at home? Mine is always much higher during an appointment than at home. Good luck

@MrsPelligrinoPetrichor and @LouisaGuy I am doing a week of home BP tests. I had an incident a few years ago where a high BP reading at the GP meant I was sent to hospital and my BP soared so much that they kept me in for days. Once they finally sent me home with a ton of medication it dropped so fast I ended up with low BP! I have been off the meds for years, but if I need them again, that’s fine. I always get high readings at the surgery now, though, because I’m scared they will send me back to hospital.

The GP made no mention of alternative HRT or starting it again or anything. She tried to tell me it was making me gain weight, but when I questioned how she would know, she checked and realised it was 8 lbs in 18 months (most of which I wasn’t on HRT) not the six weeks she had said!

I know BP is serious and I am not ignoring it, but I can’t find anything that suggests she is right to just tell me to stop it. And I am scared of going back to the state I was in before I started it.

I have decided to continue with it, do the BP readings and ask to see another GP for a second opinion.

I only taken my BP at home now, they don't even attempt it at the surgery now as I only have to see the monitor and it rises 🙄😂I take it at home regularly and submit readings via a link on line they provide me with.

In the same way the pill can cause hypertension in a small number of women, HRT can as well.
It is a recognised side effect and increases the risk of stroke which is why your GP quite rightly has asked you to stop taking it.

If your BP returns to normal they will be able to determine whether it is HRT induced.

You are right that HRT is not contraindicated with hypertension but if the drug triggers a significant rise in blood pressure then it is classed as a side effect.

I have hypertension but it has been controlled for years. I recently changed medications for the hypertension. The new meds caused paradoxical high blood pressure rather than lowering it. It was not very pleasant. so I was put back on the old ones.

When I took HRT it had no effect on my BP.
Even if you were to take meds to lower your BP the HRT may still cause problems.

As others have said, BP needs to be controlled if you want to go on HRT and have high blood pressure.

I have chronic hypertension and am on BP meds for life. I recently went on HRT and there was no concern from the doctors, I just have to keep an eye on it. I don't check it that regularly but every now and again I will make sure to take two readings a day for a week or so to get a proper average reading.