THIS week I answer questions from two readers, one on the subject of cardiovascular medicine, the other regarding the menopause. My advice is given in line with current thinking and practice, but cannot be a substitute for consulting your own GP.

Question - I attended an NHS health check and was flabbergasted to be told I had high blood pressure. I can’t understand how. I’m 45, I’ve never smoked, I rarely drink and I cook from scratch mostly – Andrew

Answer – high blood pressure cannot be diagnosed on one reading alone, unless very high. Usually, it is made on several figures, collected over a few weeks.

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You lead what sounds to be a very healthy life, which may reduce the risk of developing high blood pressure. Yet many healthy individuals do develop hypertension.

With age, calcium is laid down in our arteries, making them harder and less able to relax. This is one reason blood pressure rises as we get older.

High blood pressure can develop in younger individuals. It is good practice to look for a cause, for example narrowing of the arteries to the kidney, or in very rare cases a tumour of the adrenal glands. Yet in the majority of instances, no clear cause is found.

Daily Echo:

I would not be despondent if it turns out after several readings that you have high blood pressure. It is important to acknowledge and treat it. Uncontrolled high blood pressure is one of the leading causes of heart attack, heart failure and stroke. Continuing with all your positive lifestyle choices may also help reduce the amount of medication you require, and keep you physically and mentally well.

Question – All my friends are telling me I should be on HRT. I’m not one for taking pills, but I wonder if it is something I ought to be using? – Myrna, 50

Answer – The symptoms of the menopause are largely due to declining levels of the hormone oestrogen.

Daily Echo:

A natural menopause is reached once you have not had a period for over 12 months. In the UK this is around 50-51 years of age. However, we now understand the perimenopause may start from as early as a woman’s late thirties. Symptoms include hot flushes, brain fog, anxiety and depression, muscle and joint aches, dry skin, hair thinning and weight gain.

If you undergo menopause before the age of 45, it is recommended that you be prescribed HRT until 50. This is so that you get enough oestrogen to reduce your risk of osteoporosis.

If you have your menopause after 50 then there is no guidance that states you must have HRT. However, if you have significant symptoms attributable to the perimenopause, it would be worth discussing these with your GP to balance the pros and cons of HRT, as well as other alternatives.