current evidence suggests that, in general, the use of HRT is not associated with an increase in blood pressure
HRT is not contraindicated in women with hypertension and women with hypertension should be able to be prescribed HRT as long as BP levels can be controlled by antihypertensive medication
rarely, idiosyncratic rises in blood pressure occur in women receiving HRT - thus HRT should be temporarily discontinued in women with resistant hypertension to assess the contribution of HRT to development of hypertension
after initiation of HRT it is prudent to monitor blood pressure - 2-3 times in the first 6 months, then 6 monthly
NICE state with respect to HRT and cardiovascular disease (3):
HRT:
does not increase cardiovascular disease risk when started in women aged under 60 years
does not affect the risk of dying from cardiovascular disease
the presence of cardiovascular risk factors is not a contraindication to HRT as long as they are optimally managed
the baseline risk of coronary heart disease and stroke for women around menopausal age varies from one woman to another according to the presence of cardiovascular risk factors
HRT with oestrogen alone is associated with no, or reduced, risk of coronary heart disease
HRT with oestrogen and progestogen is associated with little or no increase in the risk of coronary heart disease
HRT should be stopped (pending investigation and treatment) if blood pressure above systolic 160 mmHg or diastolic 95 mmHg (4)
Ramsey LE et al (1999). Guidelines for the management of hypertension: report of the third working party of the British Hypertension Society, 1999. J Hum Hypertens, 13, 569-92.
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