Abstract
BACKGROUND: Hypertension, a significant modifiable risk factor for cardiovascular disease, is increasingly prevalent among middle-aged and older women due to hormonal changes, rising obesity, and lifestyle factors. However, in Bangladesh, limited research exists on the link between early menarche, late menopause, and obesity in relation to hypertension risk. Therefore, this study aimed to examine these associations and assess whether obesity contributes to the development of hypertension, providing insight for effective prevention strategies targeting aging women. METHODS: This cross-sectional, community-based study included 301 menopausal women from Dhaka district, Bangladesh. A pre-tested semi-structured questionnaire was used to assess socio-demographic, women-specific, and diet- and lifestyle-related factors. Anthropometric measurements included height, weight, waist circumference, and hip circumference. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, a previous physician’s diagnosis, or current use of antihypertensive medications. Binary logistic regression was performed to identify independent risk factors for hypertension. RESULTS: The mean age of women was 51.63 years (SD ± 5.775), and the prevalence of hypertension was 46.2%. Women who experienced late menopause (≥ 46 years) (AOR = 4.07, 95% CI: 1.80–9.19), and early menarche (≤ 12 years) (AOR = 4.29, 95% CI: 1.44–12.74) had a higher risk of developing hypertension. One important associated factor in this association was obesity (AOR = 7.18, 95% CI: 1.95–26.42), which was indicated by high BMI and larger waist circumferences (≥ 104.14 cm) (AOR = 4.98, 95% CI: 1.23–20.18). Additionally, the study showed that a significant numberof women had sedentary lifestyles (97.0%), were uneducated (42.9%), and had lower monthly wages (67.8%). The study also revealed the association of independent factors such as the use of contraceptive medications, menstrual irregularities, and high salt intake with hypertension. CONCLUSION: Early menarche and late menopause are associated with an increased risk of hypertension among middle-aged and older Bangladeshi women. Obesity and central adiposity appear to be associatedwith this relationship. Targeted public health interventions focusing on lifestyle modification, obesity management, and awareness campaigns are essential. Maintaining a healthy body weight and adopting healthy lifestyle practices may help reduce the risk of developing hypertension in this population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-026-04282-9.