# Risk Factors Associated with Systemic Arterial Hypertension in Postmenopausal Women Engaged in Resistance Training: A Cross-Sectional Observational Study

## TL;DR

Postmenopausal women who do resistance training still face high blood pressure risks, especially if they have belly fat or low education.

## Contribution

Identifies central adiposity and lower educational level as key risk factors for hypertension in physically active postmenopausal women.

## Key findings

- Central adiposity (waist circumference >88 cm) was strongly associated with systemic arterial hypertension.
- Lower educational level significantly increased the likelihood of hypertension.
- Resistance training alone may not mitigate cardiovascular risk in the presence of these factors.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Systemic arterial hypertension (SAH) remains highly prevalent among postmenopausal women, even in those engaged in structured resistance training programs.Central adiposity and lower educational level were identified as key factors associated with SAH in physically active older women, highlighting persistent cardiovascular vulnerability in this population.

Systemic arterial hypertension (SAH) remains highly prevalent among postmenopausal women, even in those engaged in structured resistance training programs.

Central adiposity and lower educational level were identified as key factors associated with SAH in physically active older women, highlighting persistent cardiovascular vulnerability in this population.

Public health significance—Why is this work of significance to public health?
This study addresses a gap in epidemiological evidence by focusing on physically active postmenopausal women, a group often underrepresented in public health analyses.Findings reinforce that physical activity level alone may not fully mitigate cardiometabolic risk when excess central adiposity and socioeconomic determinants are present.

This study addresses a gap in epidemiological evidence by focusing on physically active postmenopausal women, a group often underrepresented in public health analyses.

Findings reinforce that physical activity level alone may not fully mitigate cardiometabolic risk when excess central adiposity and socioeconomic determinants are present.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Public health strategies targeting postmenopausal women should integrate resistance training with interventions aimed at reducing central adiposity and addressing social determinants such as educational inequality.Multidisciplinary and preventive approaches are essential to monitor and manage cardiovascular risk factors in aging women, even among those classified as physically active.

Public health strategies targeting postmenopausal women should integrate resistance training with interventions aimed at reducing central adiposity and addressing social determinants such as educational inequality.

Multidisciplinary and preventive approaches are essential to monitor and manage cardiovascular risk factors in aging women, even among those classified as physically active.

Background: Systemic arterial hypertension (SAH) shows a high prevalence among postmenopausal women and represents an important public health concern. Objective: To evaluate factors associated with SAH in postmenopausal women participating in a resistance training program. Methods: This observational, cross-sectional study included 55 postmenopausal women (66.0 ± 4.9 years) recruited from the “More Active Women” research project, an umbrella experimental and longitudinal study involving resistance training interventions. Cross-sectional data were collected during the baseline assessment (April–May 2025). Sociodemographic variables, nutritional status (body mass index and waist circumference), and behavioral and health-related variables obtained through structured interviews and anthropometric assessments were analyzed. Associations were tested using Pearson’s chi-square test or Fisher’s exact test, with effect size estimated by Phi or Cramer’s V when appropriate, and binary logistic regression was performed for adjusted analyses. Results: Significant associations were observed between SAH and elevated BMI (p = 0.03; φ = 0.30), waist circumference > 88 cm (p = 0.006; φ = 0.40), and lower educational level (p = 0.003; V = 0.47). In the adjusted analysis, waist circumference ≤ 88 cm was associated with a lower likelihood of SAH (OR = 5.54; 95% CI: 0.965–31.872; p = 0.007), whereas lower educational level was associated with a higher likelihood of hypertension (OR = 13.98; 95% CI: 1.505–129.833; p = 0.004). Conclusion: Excess central adiposity and lower educational level are associated with SAH in postmenopausal women, highlighting the importance of integrated health promotion strategies that address both cardiometabolic risk factors and social determinants of health during aging.