Blood pressure generally increases after menopause. Some doctors think this increase suggests that shifting hormones related to menopause are to blame. Others think an increase in body mass index (BMI) in menopausal women may be the more likely culprit.
Changes in hormones during menopause can lead to weight gain and make your blood pressure more sensitive to salt in your diet — which, in turn, can lead to higher blood pressure. Some types of hormone therapy (HT) for menopause also may lead to higher blood pressure.
In premenopausal women, endogenous estrogens maintain vasodilation and thus contribute to blood pressure control. Aging and the loss of endogenous estrogen production after menopause are accompanied by increases in blood pressure, contributing to the high prevalence of hypertension in older women.
Elevations in blood pressure in women are related to cardiovascular risk with the prevalence of hypertension being particularly high among women aged ≥60 years. In the United States, ≈75% of postmenopausal women are hypertensive.
Mayo Clinic: Menopause and high blood pressure: What's the connection?