Pośnik-Urbańska Aneta, Kawecka-Jaszcz Kalina
I Klinika Kardiologii i Nadciśnienia Tetniczego, Collegium Medicum, Uniwersytet Jagielloński, Kraków.
Przegl Lek. 2006;63(12):1313-7.
Arterial hypertension is one of the major coronary risk factors for cardiovascular diseases. In women after menopause blood pressure is increased. The mechanisms responsible for the postmenopausal increase in blood pressure are complex and various factors may have some influence on it. A key-role in etiology of postmenopausal hypertension plays a decrease of estrogen production. Hormone replacement therapy in postmenopausal women does not effect significantly blood pressure values. This suggests that the lower level of estrogens is not only one factor in the etiology of hypertension in women in this period. Various elements have been proposed to play a role in etiology of postmenopausal hypertension, such as activation of the sympathetic nervous system, activation of the renin-angiotensin-aldosterone system, endothelium dysfunction, increase in endothelin and oxidative stress, and more common presence of other risk factors for cardiovascular diseases. These include: dyslipidemia, obesity, glucose intolerance and diabetes mellitus type 2, which are correlated with increased risk of cardiovascular complications of arterial hypertension. It is believed that insulin resistance and hyper-insu-linemia provide a link between these disorders and autonomic dysfunction. Many experimental and clinical studies will be necessary to evaluate the importance of the variety of mechanisms described in this review.
动脉高血压是心血管疾病的主要冠状动脉危险因素之一。绝经后女性的血压会升高。绝经后血压升高的机制很复杂，多种因素可能对其有一定影响。雌激素分泌减少在绝经后高血压的病因中起关键作用。绝经后女性的激素替代疗法对血压值没有显著影响。这表明雌激素水平降低并非这一时期女性高血压病因中的唯一因素。已提出多种因素在绝经后高血压的病因中起作用，如交感神经系统激活、肾素 - 血管紧张素 - 醛固酮系统激活、内皮功能障碍、内皮素增加和氧化应激，以及心血管疾病其他危险因素更常见的存在。这些因素包括：血脂异常、肥胖、葡萄糖不耐受和2型糖尿病，它们与动脉高血压心血管并发症风险增加相关。据信胰岛素抵抗和高胰岛素血症在这些疾病与自主神经功能障碍之间建立了联系。需要进行许多实验和临床研究来评估本综述中描述的各种机制的重要性。
