Bertone-Johnson Elizabeth R, Whitcomb Brian W, Rich-Edwards Janet W, Hankinson Susan E, Manson JoAnn E
Am J Epidemiol. 2015 Dec 15;182(12):1000-9. doi: 10.1093/aje/kwv159. Epub 2015 Nov 24.
The prevalence of hypertension is increasing among younger women, and new strategies are needed to identify high-risk women who should be targets for early intervention. Several mechanisms underlying hypertension might also contribute to premenstrual syndrome (PMS), but whether women with PMS have a higher risk of subsequently developing hypertension has not been assessed. We prospectively evaluated this possibility in a substudy of the Nurses' Health Study II. Participants were 1,257 women with clinically significant PMS (1991-2005) and 2,463 age-matched comparison women with few menstrual symptoms. Participants were followed for incident hypertension until 2011. Over 6-20 years, hypertension was reported by 342 women with PMS and 541 women without. After adjustment for age, smoking, body mass index, and other risk factors for hypertension, women with PMS had a hazard ratio for hypertension of 1.4 (95% confidence interval: 1.2, 1.6) compared with women without PMS. Risk was highest for hypertension that occurred before 40 years of age (hazard ratio = 3.3; 95% confidence interval: 1.7, 6.5; P for interaction = 0.0002). The risk associated with PMS was not modified by use of oral contraceptives or antidepressants but was attenuated among women with high intakes of thiamine and riboflavin (P < 0.05). These results suggest that PMS might be associated with future development of hypertension and that this risk may be modifiable.
高血压在年轻女性中的患病率正在上升，因此需要新的策略来识别那些应作为早期干预目标的高危女性。高血压的几种潜在机制可能也与经前综合征（PMS）有关，但患有经前综合征的女性随后发生高血压的风险是否更高尚未得到评估。我们在护士健康研究II的一项子研究中对这种可能性进行了前瞻性评估。参与者为1257名有临床显著经前综合征的女性（1991 - 2005年）和2463名年龄匹配、月经症状较少的对照女性。对参与者随访至2011年，观察高血压发病情况。在6至20年期间，有342名经前综合征女性和541名无经前综合征女性报告患高血压。在对年龄、吸烟、体重指数和其他高血压危险因素进行调整后，与无经前综合征的女性相比，有经前综合征的女性患高血压的风险比为1.4（95%置信区间：1.2, 1.6）。40岁之前发生高血压的风险最高（风险比 = 3.3；95%置信区间：1.7, 6.5；交互作用P值 = 0.0002）。经前综合征相关风险不受口服避孕药或抗抑郁药使用的影响，但在硫胺素和核黄素摄入量高的女性中有所降低（P < 0.05）。这些结果表明，经前综合征可能与未来高血压的发生有关，且这种风险可能是可改变的。
