Premature menopause is associated with the development of high blood pressure: a UK Biobank cohort study

OBJECTIVES: Hormonal fluctuations during menopause may contribute to an increased risk of hypertension. Evidence of a direct association is not well defined. The objective of this study was to analyze the association between premature (<40 y of age) and early menopause (40-45 y) and the onset of hypertension in the UK Biobank database. METHODS: A prospective observational cohort study was conducted in postmenopausal women in the UK Biobank database. Enrollment was between 2006 and 2010, with follow-up until the end of 2023. The outcome variable was the diagnosis of hypertension during follow-up. Lifestyle behaviors, comorbidities, and laboratory tests were collected. Survival models with Weibull distribution were fitted to the time of onset of hypertension. RESULTS: Of a total of 107,836 women with a mean follow-up of 14.5 years, 18,508 cases of hypertension were observed (17.2%). The cumulative incidence increased with earlier menopause onset: 16.6% in normal menopause, 18.8% in early menopause, and 22.6% in premature menopause (χ2 test, P<0.001). Incidence of hypertension was higher in women with surgical menopause, but there was no association in the multivariate model. The effect of premature menopause was maintained in the multivariate model, with a 12.3% higher risk of developing hypertension. CONCLUSIONS: Premature menopause had a significant effect on the development of hypertension during follow-up. Surgical menopause did not have a significant, independent effect.