Schillaci G, Verdecchia P, Borgioni C, Ciucci A, Sacchi N, Benemio G, Porcellati C
Effect of menopause on day-night blood pressure changes and left ventricular function in hypertension
12th Annual ASH Meeting
Am J Hypertens (Apr) 10:12A 1997

Age has been shown to be a predictor of a blunted day-night blood pressure reduction. The effect of hormonal changes associated with menopause have not been evaluated as an independent factor in altered day- night pressure in hypertensive patients. This study was uniquely designed to look at ambulatory blood pressure changes in age matched hypertensive women either with normal ovulatory cycles or menopausal.

76 consecutive untreated hypertensive women aged 45-55 with a normal ovulatory cycle were selected and matched with 76 hypertensive post-menopausal women. The women were individually matched for age (± 5 years) and office systolic and diastolic blood pressures (both ± 5 mmHg) In a case control design. Echocardiography and 24 hour ambulatory blood pressure were performed on all patients. Patients with suboptimal ECHO, use of estrogens, shift work, and diabetes were excluded. Awake and sleep periods were determined by diaries.

Matching age and office blood pressure did not differ, Daytime BP, smoking status, sleep duration and body mass index also did not differ. Menopause was associated with a blunted nocturnal BP fall (sleep SBP/DBP fall, %, control 16/21, menopause 12/17), a higher sleep BP (control 119/72, menopause 123/75), an altered left ventricular diastolic filling pattern and a non significant increase in LV mass as compared to ovulatory women.

Comment: This well designed case control study shows the effects of menopause independent of age in hypertensive women. (Betsy Ripley, M.D., Medical College of Virginia)

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12th Annual ASH Meeting
H: Special problems : Women
H: Exam and lab tests : Ambulatory monitoring