High Blood Pressure During Pregnancy Linked to Increase Risk of Menopausal Symptoms

Stephanie Faubion, MD

New research from a Mayo Clinic-led team of physicians suggests high blood pressure during pregnancy could be a predictor of increased risk of menopausal symptoms later in life.

An analysis of data from more than 2500 women seen at Mayo Clinic facilities between 2015 and 2019, results indicate a history of hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, was associated with increased risk of menopausal symptoms.

"We already know that women with high blood pressure during pregnancy or those who experience menopause symptoms such as hot flashes and night sweats have a higher risk of developing heart disease,” said study lead investigator Stephanie Faubion, MD, Director of the Mayo Clinic’s Center for Women’s Health, in a statement from the North American Menopause Society. “Our research discovered that women who experienced high blood pressure during pregnancy were much more likely to experience bothersome menopausal symptoms, including hot flashes and night sweats during menopause.”

While associations between hypertensive disorders of pregnancy and vasomotor menopausal symptoms with cardiovascular disease risk have been thoroughly investigated, few studies have examined associations between the risk factors. With this in mind, Faubion and a team of colleagues sought to describe associations between a history of a hypertensive disorder of pregnancy and menopausal symptoms through a cross-sectional analysis of women from 2 Mayo Clinic women’s health centers.

Using the women’s health clinics at Mayo Clinic facilities in Rochester, MN and Scottsdale, AZ from May 2015 through September 2019, investigators identified a cohort of 2684 women aged 40-65 years who were seen for specialty menopause or sexual health consultations for inclusion in their study. All women included in the study completed the Menopause Rating Scale (MRS) and a questionnaire containing questions related to self-reported history of hypertensive disorders of pregnancy, gestational diabetes, reproductive stage, and use of systemic menopausal hormone therapy. Of note, investigators obtained demographic information related to these patients through use of medical records.

For the purpose of analysis, women included in the study were categorized into 3 subgroups according to pregnancy history. These groups were defined as no pregnancy, pregnancy and no hypertensive disorder of pregnancy, and pregnancy complicated by hypertensive disorder of pregnancy.

Of the 2684 women included in the analysis, 402 had no history of pregnancy, 2102 had a pregnancy but no history of self-reported history of hypertensive disorder of pregnancy, and 180 had a self-reported history of hypertensive disorder of pregnancy.

Upon analysis, investigators found total menopausal symptom scores were higher in women with a history of a hypertensive disorder of pregnancy compared to those without a history of a hypertensive disorder of pregnancy or to women without a pregnancy. Additionally, women with a self-reported history of hypertensive disorder of pregnancy had higher somatic and psychological domain scores compared to women without a history of hypertensive disorder of pregnancy or to women without a pregnancy.

In a multivariable analysis, results indicated women with self-reported hypertensive disorder of pregnancy using hormone therapy had significantly higher total menopause symptom scores than women without a history of hypertensive disorder of pregnancy.

"This study is another reminder that these women are different,” added Faubion. “It is important that they not only receive education with regard to what they may experience during menopause, but also that they undergo routine screenings and counseling on how they can reduce their risk for heart disease."

This study, “Hypertensive disorders of pregnancy and menopausal symptoms: a cross-sectional study from the data registry on experiences of aging, menopause, and sexuality,” was published in Menopause: The Journal of the North American Menopause Society.