Olszanecka Agnieszka, Pośnik-Urbańska Aneta, Kawecka-Jaszcz Kalina, Czarnecka Danuta
1st Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland.
Pol Arch Med Wewn. 2010 Oct;120(10):390-8.
Hypertension and its complications are more common in postmenopausal women than before menopause. However, whether this is due to the effect of age or menopause is still unknown.
The aim of the study was to assess the effect of menopause on blood pressure (BP), left ventricular and vascular structure and function, as well as kidney function in perimenopausal women.
The study involved 192 women aged 40 to 60 years (mean age, 51.73 ±1.82 years), including 152 with newly diagnosed essential hypertension and 40 normotensive controls matched for age. In all subjects, 24-hour BP monitoring was performed. Echocardiographic examination with the assessment of left ventricular mass (LVM) and systolic and diastolic function,as well as carotid ultrasound with the measurement of intima-media thickness (IMT) in the common carotid artery were performed. Carotid-femoral pulse wave velocity (PWV) was measured. Glomerular filtration rate (eGFR) was calculated and urinary albumin-creatinine ratio (UACR) was measured.
The study group was divided according to hypertension and menopausal status into 4 subgroups: normotensive premenopausal, normotensive postmenopausal, hypertensive premenopausal, and hypertensive postmenopausal women. Menopause did not affect BP or LVM. Differences in LVM between pre- and postmenopausal women were dependent on age and the body mass index. Hypertensive postmenopausal compared with hypertensive premenopausal women had significantly higher IMT (0.72 ±0.34 mm vs. 0.59 ±0.30 mm, P = 0.001) and a lower ratio of early to late mitral inflow velocity (E/A, 1.04 ±0.32 vs. 1.32 ±0.33, P = 0.01). PWV was higher in hypertensives compared to controls (9.7 ±1.6 m/s vs. 8.4 ±1.2 m/s, P = 0.001), without differences between premenopausal and postmenopausal women. Menopause did not affect eGFR and UACR either in the hypertensive or normotensive group.
Left ventricular diastolic function and carotid IMT are independently associated with menopausal status in both normo- and hypertensive women. Menopause per se did not affect BP in the examined group.
绝经后女性的高血压及其并发症比绝经前更为常见。然而，这是由于年龄的影响还是绝经的影响仍不清楚。
本研究的目的是评估绝经对围绝经期女性血压（BP）、左心室及血管结构和功能以及肾功能的影响。
本研究纳入了192名年龄在40至60岁之间（平均年龄51.73±1.82岁）的女性，其中包括152名新诊断的原发性高血压患者和40名年龄匹配的血压正常对照者。对所有受试者进行24小时血压监测。进行超声心动图检查以评估左心室质量（LVM）以及收缩和舒张功能，同时进行颈动脉超声检查以测量颈总动脉的内膜中层厚度（IMT）。测量颈动脉-股动脉脉搏波速度（PWV）。计算肾小球滤过率（eGFR）并测量尿白蛋白-肌酐比值（UACR）。
研究组根据高血压和绝经状态分为4个亚组：血压正常的绝经前女性、血压正常的绝经后女性、高血压的绝经前女性和高血压的绝经后女性。绝经不影响血压或左心室质量。绝经前后女性左心室质量的差异取决于年龄和体重指数。与高血压的绝经前女性相比，高血压的绝经后女性的内膜中层厚度显著更高（0.72±0.34毫米对0.59±0.30毫米，P = 0.001），二尖瓣流入速度的早/晚比值更低（E/A，1.04±0.32对1.32±0.33，P = 0.01）。与对照组相比，高血压患者的脉搏波速度更高（9.7±1.6米/秒对8.4±1.2米/秒，P = 0.001），绝经前和绝经后女性之间无差异。绝经对高血压组或血压正常组的肾小球滤过率和尿白蛋白-肌酐比值均无影响。
在血压正常和高血压女性中，左心室舒张功能和颈动脉内膜中层厚度均与绝经状态独立相关。绝经本身对所研究组的血压无影响。
