School of Public Health, The University of Queensland, Queensland, Australia.
Illawarra Health and Medical Research Institute & School of Medicine, University of Wollongong, New South Wales, Australia.
Maturitas. 2021 Jan;143:17-24. doi: 10.1016/j.maturitas.2020.08.006. Epub 2020 Aug 18.
To investigate whether menstrual symptoms are associated with increased risk of hypertension among young women, and whether the relationship is bi-directional.
We included 7729 women participating in the Australian Longitudinal Study on Women's Health, aged 22-27 years in 2000 and who were followed up every 3 years until 2015. Premenstrual syndrome, painful (dysmenorrhoea), heavy (menorrhagia), and irregular menstrual periods over the previous 12 months were self-reported and recorded as 'never', 'rarely', 'sometimes', or 'often'. Questions regarding physician-diagnosed hypertension were asked, specifically for other than during pregnancy (defined as chronic hypertension) and during pregnancy (hypertensive disorder in pregnancy, HDP). Longitudinal data were analysed with generalised estimating equation time-lagged models to estimate relative risks (RRs) and 95 % confidence intervals (CI), adjusted for time-varying covariates.
Chronic hypertension, HDP, and menstrual disorders.
Over 15 years of follow-up, 757 women (9.8 %) reported having been diagnosed with chronic hypertension. Among 4473 parous women, 483 (10.8 %) reported a diagnosis of HDP. Women who often experienced heavy periods had an increased risk of incident chronic hypertension (RR 1.53, 1.13-2.09), compared with those who had not experienced heavy periods. We also found that women with chronic hypertension had an increased risk of incident heavy (RR 1.23, 1.02-1.50) and irregular periods (RR 1.42, 1.17-1.72). However, there was no apparent association between any menstrual symptoms and subsequent risk of HDP.
The association between heavy periods (menorrhagia) and chronic hypertension may be bi-directional in young women. Chronic hypertension may also be associated with subsequent risk of irregular periods.
探讨月经症状是否与年轻女性高血压风险增加有关，以及这种关系是否具有双向性。
我们纳入了 7729 名参加澳大利亚女性健康纵向研究的女性，她们在 2000 年时年龄为 22-27 岁，并在 2000 年至 2015 年期间每 3 年进行一次随访。月经前综合征、疼痛（痛经）、大量（月经过多）和 12 个月内月经不规律的情况是通过自我报告来记录的，分为“从不”、“很少”、“有时”或“经常”。询问了关于医生诊断为高血压的问题，具体是指除怀孕期间（定义为慢性高血压）和怀孕期间（妊娠高血压疾病，HDP）以外的高血压。使用广义估计方程时间滞后模型对纵向数据进行分析，以估计相对风险（RR）和 95%置信区间（CI），并根据时间变化的协变量进行调整。
慢性高血压、HDP 和月经紊乱。
在 15 年的随访期间，有 757 名女性（9.8%）报告被诊断为慢性高血压。在 4473 名经产妇中，有 483 名（10.8%）报告了 HDP 的诊断。与未经历过多经期间的女性相比，经常经历过多经的女性发生偶发性慢性高血压的风险增加（RR 1.53，1.13-2.09）。我们还发现，患有慢性高血压的女性发生过多经（RR 1.23，1.02-1.50）和不规则月经的风险增加（RR 1.42，1.17-1.72）。然而，月经症状与随后发生 HDP 的风险之间似乎没有明显的关联。
在年轻女性中，过多经（月经过多）与慢性高血压之间的关联可能是双向的。慢性高血压也可能与随后不规则月经的风险相关。
