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High Blood Pressure

Does HRT increase blood pressure?

03/03/2000

Question:

Answer:

Estrogen replacement therapy given to postmenopausal women very rarely causes elevation in blood pressure. Several large studies have shown no change in blood pressure or even a slight decrease. Women who already are hypertensive generally experience no further increase in blood pressure when taking estrogen replacements.

The beneficial effects of postmenopausal estrogen have been well documented. They decrease the risk for stroke and heart disease. The small increase in endometrial or breast cancer risk is far outweighed by their protective effects.

Oral contraceptives carry a small risk of causing high blood pressure. In most women taking birth control pills, the blood pressure will rise slightly, and a few will become hypertensive. One has to keep in mind, however, that low-dose oral contraceptives do not increase overall mortality risk.

It is not entirely clear why oral contraceptives have a slight tendency to elevate blood pressure, while postmenopausal estrogen replacement does not.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati