24-hour blood pressure profile analysis and comorbid pathology in postmenopausal female ­patients not receiving antihypertensive therapy

Abstract

Aim. Assessment of ambulatory blood pressure monitoring data depending on the Charlson comorbidity index in postmenopause.
 Methods. A cross-sectional study included 129 outpatients who did not receive medical treatment for hypertension. Median age was 58.5 (54.062.0) years, postmenopause duration 9 (4.012.0) years. Investigation included medical history registration, physician examination by an internist, anthropometry with measurement of body mass, height with further body mass index calculation. Comorbid conditions were diagnosed according to current clinical guidelines. All females had ambulatory 24-hour blood pressure monitoring. Based on Charlson comorbidity index, the subjects were divided into groups with moderate comorbidity (Charlson index 2, group 1) and high comorbidity (Charlson index 2, group 2).
 Results. Females from group 2 were significantly older, had a longer duration of postmenopause and the severity of menopausal symptoms, higher body mass index values, functional limitations due to osteoarthritis, higher maximum and average 24-hour, average daily and average night systolic blood pressure levels as well as time index. No differences were revealed in the prevalence of females with night increase or absence of sufficient decrease of blood pressure at night. The absence of antihypertensive treatment in multimorbid postmenopausal females was associated with significant menopausal symptoms persistence.
 Conclusion. Blood pressure monitoring in multimorbid females can reveal higher average daily values of systolic and diastolic blood pressure, higher variability during 24 hour of systolic blood pressure and greater index of time of systolic blood pressure, which can be considered as a cardiovascular disease progression predictor; uncontrolled hypertension and persistence of neurovegetative symptoms of menopausal syndrome may be the markers of a higher risk of premature death compared to the assessment by Charlson index score.