Which statement about hypertension risk after menopause is true?

Which statement about hypertension risk after menopause is true?

• A. Hypertension risk decreases after menopause
• B. Hypertension risk is unrelated to estrogen status
• C. Estrogen loss contributes to higher blood pressure risk
• D. There is no change in hypertension prevalence

Answer: (C)

Estrogen withdrawal during menopause removes a layer of vascular protection, which raises the risk of developing hypertension. Estrogen promotes endothelial nitric oxide production and vasodilation, and it helps keep endothelin levels in check; when estrogen falls, endothelial function can decline and arterial resistance tends to rise. It also interacts with the renin-angiotensin-aldosterone system, and its loss can favor sodium retention and higher blood pressure. In addition, menopause brings changes in body composition—more central fat—and arteries tend to stiffen with age, all of which contribute to higher blood pressure risk after menopause. Therefore, estrogen loss contributing to higher blood pressure risk is the true statement. The ideas that risk decreases after menopause, is unrelated to estrogen, or that there’s no change in prevalence don’t fit with these mechanisms and population patterns.

Estrogen withdrawal during menopause removes a layer of vascular protection, which raises the risk of developing hypertension. Estrogen promotes endothelial nitric oxide production and vasodilation, and it helps keep endothelin levels in check; when estrogen falls, endothelial function can decline and arterial resistance tends to rise. It also interacts with the renin-angiotensin-aldosterone system, and its loss can favor sodium retention and higher blood pressure. In addition, menopause brings changes in body composition—more central fat—and arteries tend to stiffen with age, all of which contribute to higher blood pressure risk after menopause. Therefore, estrogen loss contributing to higher blood pressure risk is the true statement. The ideas that risk decreases after menopause, is unrelated to estrogen, or that there’s no change in prevalence don’t fit with these mechanisms and population patterns.