Effects of Candesartan for Middle-Aged and Elderly Women with Hypertension and Menopausal-Like Symptoms

Abstract

Hypertension in middle-aged or elderly women is often accompanied with various symptoms, which may be related to climacteric. The symptoms of post-menopausal women are suggested to be derived in part from instability of the sympathetic nerve system due to a low estrogen state. An angiotensin-receptor blocker, candesartan cilexetil (candesartan), is known to suppress sympathetic nerve activity by inhibiting the renin-angiotensin system in the brain, suggesting that it may be effective for ameliorating these symptoms. The aim of this study was to elucidate whether candesartan improves menopausal symptoms in hypertensive women. A total of 69 female patients, aged 40 years or older, who had hypertension and various menopausal-like symptoms, were recruited from 39 centers to participate in this study. Patients were prescribed candesartan 4 to 8 mg/day (average dose 7.2 mg/day), alone or in addition to current antihypertensive medications. We interviewed patients in regard to their menopausal symptoms and scored them using the Simplified Menopausal Index (SMI). During the 12-month observation period, significant decreases were seen in both blood pressure (157+/-21/85+/-11 to 141+/-18/77+/-12 mmHg, p<0.001) and SMI (29+/-18 to 18+/-7, p<0.001), although the heart rate did not change. The percentage of decrease in SMI was correlated with that in systolic blood pressure (r=0.43, p<0.001). Candesartan may be an effective antihypertensive agent to relieve menopausal-like symptoms in middle-aged or elderly hypertensive women.