Correlation of non-HDL cholesterol to ankle - brachial systolic index in pre- and post - menopausal untreated newly diagnosed essential hypertensive women

Abstract

Measured simply, easily reproduced and well associated assays to cardiovascular risk (CVR) in hypertensive subjects are non-HDL-C estimation and ankle-brachial systolic index (ABSI) determination. Menopause constitutes a period of abrupt change in CVR. In this setting, we investigated the possible correlation of non-HDL-C with ABSI in pre-menopausal and post-menopausal essential hypertensive women. For this, we used 81 untreated newly diagnosed essential hypertensive women (48 premenopausal and 33 postmenopausal) mean aged 52.6±11.1 years, with office blood pressure (BP) 159.3/99.6±19.8/9.25 mmHg and body mass index 26.4±2.6 kg/m2. All women underwent measurements of total cholesterol (TC) and HDL-C levels (non-HDL-C=TC-HDL-C) and determination of ABSI with a hand-held Doppler according to established methods. The lower ABSI value was used for our study between right and left limb side measurements. Non-HDL-C levels were higher in postmenopausal women compared to premenopausal (201.9±38.46 vs. 166.1±41.9 mg/dl, p=0.0001). Increased levels of ABSI were noticed in postmenopausal women compared to premenopausal group (1.13±0.1 vs. 1.08±0.1, p=0.05). Non-HDL-C was correlated to ABSI only in the population of postmenopausal women (r=0.334, p<0.05) as well as in the total study population (r=0.241, p=0.036) but not in premenopausal hypertensive women (r=0.123, p=NS). By applying a multivariate regression analysis model in the population of postmenopausal hypertensive patients including age, BMI, systolic and diastolic office BP, ABSI and non-HDL levels as independent variables it was revealed that non-HDL was significantly correlated to BMI and ABSI (p<0.05 for both cases).In conclusion, non-HDL-C was significantly correlated to ABSI in middle aged hypertensive women. This correlation remains significant in postmenopausal hypertensive women but not in premenopausal hypertensive women. In this setting, postmenopausal women with impaired ABSI and higher levels of non-HDL-C might be considered a possible group of increased CVR. Furthermore, the use of low cost accurate methods like the ones used above, may prove effective for initial screening assessment of CVR in such subjects.