Jose Miguel Sanchez/ Alamy Stock Photo
Women who reach menopause before the age of 40 years face a meaningfully higher risk of developing high blood pressure compared with those who go through menopause after the age of 45 years, according to the results of a study.
Publishing their findings in Menopause, the journal of The Menopause Society, on 29 July 2026, researchers analysed data from 107,836 postmenopausal women who enrolled in the UK Biobank between 2006 and 2010, with a median follow-up period of 14.5 years.
While the hormonal fluctuations women experience throughout their lives can contribute to weight gain and female-specific fat distribution patterns, which are associated with increased risk of diabetes and hypertension, the evidence for a direct association between the onset of menopause and diabetes or hypertension is “not fully defined”, the study authors said.
The study classified women by age at menopause into three categories: normal (after the age of 45 years), early (at the age of 40–45 years) and premature (before the age of 40 years). During the study, participants were also categorised by type of menopause (natural versus surgical) and monitored for new diagnoses of high blood pressure over time.
The researchers observed that over the follow-up period, 18,508 women (17.2%) were diagnosed with hypertension. The risk climbed steadily as age at menopause dropped: 16.6% (10.6 cases per 1,000 women-years) of women with normal age at menopause developed hypertension, compared with 18.8% (10.9 cases per 1,000 women-years) of women with early menopause and 22.6% (10.8 cases per 1,000 women-years) of women with premature menopause, they noted.
After adjusting for more than 50 variables, including weight, lifestyle habits, family history and lab values, the researchers highlighted that women with premature menopause still had a 12.3% higher risk of developing hypertension than women who reached menopause after the age of 45 years.
A further analysis modelling of age at menopause on a continuous scale found that risk peaked not at the traditional premature-menopause cutoff age of 40 years but between the ages of 25 years and 35 years, which suggests that the cardiovascular risk associated with premature menopause may be concentrated in an even younger group of women than previously defined.
Surgical menopause was associated with higher hypertension rates in initial analyses, but that association did not hold once other risk factors were considered, the researchers noted.
Based on these findings, the study authors recommended that clinicians treat age at menopause as a distinct cardiovascular risk factor, particularly for women who reach menopause before the age of 40 years.
In addition to individualised counselling on hormone therapy, they said earlier identification and management of high blood pressure was an opportunity to help reduce long-term cardiovascular risk in this group of women.
The study authors also acknowledged the study’s limitations, which included the inherent selection bias in UK Biobank participants, potential survival bias, self-reported age at menopause, possible heterogeneity in the definition of hypertension and the existence of residual confounding factors, as well as the relatively homogeneous population of predominantly European descent.
However, they said the study’s strengths contributed to the existing evidence on the association between early menopause and hypertension, as well as providing a solid foundation for future research.
Stephanie Faubion, medical director for The Menopause Society, said: “The results of this study highlight the potential adverse long-term health outcomes associated with premature menopause, and in particular, the need to regularly screen for cardiovascular risk factors such as hypertension.
“Use of hormone therapy is also routinely recommended in women with premature menopause, at least until the natural age of menopause, unless contraindications exist.”
The findings of a large multinational cohort study, published in Lancet Obstetrics, Gynaecology & Women’s Health in June 2026, revealed that premature and early menopause were consistently associated with a greater risk of major cardiovascular events, including myocardial infarction, fatal cardiovascular disease and stroke, across all regions and ethnic groups studied.
In April 2026, several pharmacy bodies, including the Royal College of Pharmacy, called for urgent action on menopause care and warned of a “significant unmet need”.
