Hypertensive Postmenopausal Women Research Articles

Hemodynamic and metabolic effects of estrogen plus progestin therapy in hypertensive postmenopausal women treated with an ACE-inhibitor or a diuretic.

ObjectivesThe aim of the study was to assess the hemodynamic and metabolic actions of estrogen plus progestin therapy (EPT) in hypertensive, postmenopausal women treated with perindopril (ACEI) or hydrochlorothiazide (HCTZ). A group of normotensive postmenopausal women was also studied.Methods100 hypertensive and 40 normotensive postmenopausal women were recruited for the study. The hypertensive females were randomly assigned to receive ACEI or HCTZ for 12 months. The patients of the ACEI group and the patients of the HCTZ group, as well as normotensives, were further subdivided into two subgroups each. One subgroup received estrogen plus progestin therapy (EPT+), the other subgroup received no hormone replacement (EPT−). Combined hormone replacement with transdermal patches releasing 17β-estradiol and norethisterone was used. Office and 24-hour ambulatory blood pressure was measured at baseline and during follow-up. Renal plasma flow (RPF) was measured using the clearance of [125I]-iodohippuran. Pulse wave velocity (PWV) was determined with an automatic device.ResultsIn normotensive postmenopausal women, transdermal estrogen plus progestin therapy increases RPF and insulin sensitivity, decreases PWV, decreases total and LDL cholesterol, and decreases uric acid serum levels. Perindopril (4 mg/day) and hydrochlorothiazide (25 mg/day) were equally effective in reducing blood pressure in postmenopausal, hypertensive subjects. In these females, perindopril increased RPF and decreased PWV and plasma insulin levels. These effects of the ACEI were not altered by estrogen plus progestin therapy. Hydrochlorothiazide decreased RPF and increased plasma insulin and uric acid concentrations in hypertensive subjects whom were not receiving estrogen plus progestin therapy.ConclusionsThe unfavorable metabolic and hemodynamic actions of the diuretic were counteracted by estrogen plus progestin therapy. Concomitant estrogen plus progestin therapy may be a method to avoid unfavorable hemodynamic and metabolic effects of thiazide diuretics in hypertensive, postmenopausal women.

Abstract 511: Influence Of Aerobic Exercise Training On Steroid Hormones And Cardiovascular Biomarkers In Hypertensive Postmenopausal Women

Evidences have shown that postmenopausal women are at increased risk of cardiovascular complications as compared with premenopausal, but the insight mechanisms are not fully understood. On the other hand, no studies have examined the interaction between endocrine and cardiovascular biomarkers in trained postmenopausal women. The aim of this study is to evaluate steroids hormones and cardiovascular biomarkers in trained hypertensive (HT) postmenopausal women at basal condition or submitted to acute challenges of L-arginine, placebo or a bout of exercise. Methods: Twenty-two women underwent to ET on treadmill, 3 days/week, 40 min, for 24 sessions, at moderate intensity. Volunteers were randomized into three groups, where an acute administration of L-arginine (9g) was given (ARG group), a challenge of a bout of aerobic exercise (30 min) was applied with placebo pills (EXE group) or the combination of the both challenges (ARG-EXE group). The challenges were applied before and after ET. Office blood pressure (BP) and ambulatory blood pressure monitoring (ABPM) were evaluated. Biochemical analyses measuring nitrite/nitrate (NOx), cGMP, total testosterone, cortisol levels and redox state were examined during the challenges and after overnight fasting, before and after ET. Effect of ET: Reduction in body mass index was found after ET whereas no changes were observed in the officce BD or ABPM. Similarly, testoterone, cortisol, NOx- and MDA levels as well as in catalase activity wre not altered. An increase in the cGMP concentration (basal: 5.0 ± 0.4 and ET: 6.3 ± 0.7 pmol/mL) and SOD activity (basal: 15.6 ± 2 and ET: 28.1 ± 1.6 u/mL) were observed after ET. Effect of challenges: Reduction in SBP (-14 mmHg) and DBP (-12 mmHg) values were observed in ARG-EXE group in office measurements. In both challenge groups (EXE and ARG-EXE), a significant increase in NOx- levels (EXE: 57% and ARG-EXE: 65%) as well as cGMP concentration (EXE: 19% and ARG-EXE: 37%) were found. Cortisol levels were significantly reduced in EXE (-21%) and ARG-EXE (-24%) groups. Conclusion: A reduction in BP that was accompanied by increased activation of the NO/cGMP pathway and a decrease in cortisol levels in trained HT women.

Modification of blood pressure in postmenopausal women: role of hormone replacement therapy.

The rate of hypertension increases after menopause. Whether estrogen and progesterone deficiency associated with menopause play a role in determining a worst blood pressure (BP) control is still controversial. Also, studies dealing with the administration of estrogens or hormone therapy (HT) have reported conflicting evidence. In general it seems that, despite some negative data on subgroups of later postmenopausal women obtained with oral estrogens, in particular conjugated equine estrogens (CEE), most of the data indicate neutral or beneficial effects of estrogen or HT administration on BP control of both normotensive and hypertensive women. Data obtained with ambulatory BP monitoring and with transdermal estrogens are more convincing and concordant in defining positive effect on BP control of both normotensive and hypertensive postmenopausal women. Overall progestin adjunct does not hamper the effect of estrogens. Among progestins, drospirenone, a spironolactone-derived molecule, appears to be the molecule with the best antihypertensive properties.

Influence of aerobic exercise training on cardiovascular and endocrine-inflammatory biomarkers in hypertensive postmenopausal women

Given that few studies have examined the interaction between endocrine-inflammatory mediators and aerobic exercise training in hypertensive postmenopausal women, the aim of this study was to investigate whether aerobic exercise training (AET) for twenty-four sessions would alter cortisol, leptin and interleukin-1β (IL-1β) levels. To further analyze endothelium function in response to AET, we also examined redox state as well as NO/cGMP pathway in this population. Eighteen hypertensive postmenopausal women finished this study. AET program consisted of 24 sessions in treadmill, 3 times per week, duration of 30 up to 40 min for each session, for 8 weeks at intensity of 100% of the MLSS according to previous incremental test. Heart rate was monitored in all studied time (resting and during exercise sessions). After 48 h of the last exercise session, blood samples were collected for biochemical analyses (levels of cortisol, leptin, IL-1β, nitrite/nitrate (NOx−), cGMP, malondialdehyde (MDA) and asymmetric dimethylarginine (ADMA); superoxide and catalase activity). We also measured systolic and diastolic blood pressure. A significant reduction in body mass was observed. As expected, systolic and diastolic blood pressure values were significantly reduced after AET in hypertensive women. We also found a marked increase in NOx− levels as well as cGMP concentration in trained women, approximately 37.7 and 30.8%, respectively. No changes in cortisol, leptin, ADMA and IL-1β levels were observed after AET. Similarly, MDA levels and catalase activity were not affected by AET. In contrast, a marked increase in SOD activity was found (86.6%). In conclusion, our findings show that aerobic exercise training for twenty-four sessions promoted a significant reduction in blood pressure by activating NO/cGMP pathway as well as by promoting an up-regulation of SOD activity without changing in cortisol/leptin levels in postmenopausal hypertensive women.

Bone metabolism and cardiovascular function update. Cross link of hypertension, bone loss and vascular calcification - common back grounds in renin angiotensin system with anti-aging aspect -

Hypertension, osteoporosis and vascular calcification are major diseases in the recent aging society and may share the same backgrounds genetically and environmentally. As treatments to prevent aging-related diseases simultaneously are desirable, we investigate common backgrounds underling these diseases. Renin- angiotensin system, which causes high blood pressure, is found to be involved in bone metabolism. Angiotensin II has been shown to accelerate osteoporosis through RANKL up-regulation in osteoblast. RANKL, in turn, contributes to vascular calcification by regulating bone morphogenetic protein-2 and MGP expression, as well as bone-related proteins. Angiotensin type 1 receptor blockers (ARBs) ameliorate osteoporosis and vascular calcification beyond their blood pressure lowering effects. These pleiotropic effects of antihypertensive drugs such as ARBs might benefit especially hypertensive postmenopausal women.

The Association between Prolactin, High-Sensitivity C-Reactive Protein and Framingham Risk Score in Menopause

Aims: To evaluate the association between serum prolactin, high-sensitivity C-reactive protein (hs-CRP) levels and cardiovascular disease risk in postmenopausal women regarding the Framingham Risk Score (FRS). Methods: Fifty-eight menopausal women were enrolled into the cross-sectional study. All participants had 24-hour ambulatory blood pressure monitoring, echocardiography, electrocardiography, and carotid intima-media thickness measurement. Blood samples were obtained for prolactin, hs-CRP, lipid profile, fasting glucose, and insulin. Results: Among the participants, 67.24% had a FRS <10%, and 32.75% had a FRS ≥10%. Levels of prolactin and hs-CRP did not differ between the FRS groups. In the FRS <10% group, significantly higher levels of prolactin were found. Cases with hypertension have significantly higher levels of hs-CRP. Prolactin and hs-CRP were found to be associated with hypertension in the FRS <10% and ≥10% groups, respectively. Conclusions: Hypertensive postmenopausal women with low risk for cardiovascular diseases have increased levels of prolactin, suggesting a possible role in the pathogenesis of hypertension. The correlation of hs-CRP with systolic blood pressure can be interpreted as a potential effect of hypertensive heart disease reflecting a state of high-risk milieu with elevated inflammatory markers.

Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial

Objectives : This study aims to evaluate the effectiveness and safety of acupuncture and explore the appropriate number of treatment for postmenopausal women diagnosed with prehypertension and stage 1 hypertension. Methods : A 4-arm randomized open label pilot trial will be performed at 2 centers. Sixty participants will be divided into 2 treatment groups and 2 control groups. Treatment groups will receive acupuncture at 8 points(bilateral GB20, LI11, ST36, SP6) for 4 weeks(treatment group A, 10 total sessions) or 8 weeks(treatment group B, 20 total sessions), while maintaining usual care. Control groups will not receive acupuncture but will be under usual care for 16 weeks(control group C) or 20 weeks(control group D). Each patient`s living habits will be corrected and drugs that may affect blood pressure(BP) will be prohibited. Treatment group A and control group C will be evaluated at 4, 8, 12, and 16 weeks after randomization, while treatment group B and control group D will be evaluated at 4, 8, 12, 16, and 20 weeks after randomization. The major outcome variable is the magnitude of change in diastolic BP levels at 4 weeks after randomization; auxiliary outcome variables are (1) diastolic BP change at 8, 16, and 20 weeks, (2) systolic BP change, (3) BP control rate, (4) lipid profiles, and (5) high-sensitivity C-reactive protein. Patient safety will be assessed at every visit. Results and Conclusions : The study findings may help develop evidence for the effectiveness and safety of acupuncture for BP control.

A susceptibility haplotype within the endothelial nitric oxide synthase gene influences bone mineral density in hypertensive women

The influence of the coordinated effect of various single-nucleotide polymorphisms (SNPs) within the endothelial nitric oxide synthase (eNOS) gene on the risk of osteoporosis in hypertension has remained undetermined. Four pertinent SNPs of the eNOS gene, rs2070774, rs1799983, rs1800780 and rs3918181, were examined for the risk of osteoporosis in 313 hypertensive postmenopausal women in Northwest India. All the hypertensive women were verified with dual energy X-ray absorptiometry and categorized as 150 with osteoporosis and 163 without osteoporosis. The minor allele (T) of rs1799983 exerts a statistically significant risk for osteoporosis both in dominant [odds ratio (OR) 3.71, 95 % confidence interval (CI) 2.12-6.49, P < 0.001] and recessive mode (OR 5.75, 95 % CI 1.24-26.69, P = 0.036) after Bonferroni correction. Bone mineral density (BMD) values (corrected for the effects of risk variables) according to eNOS SNP genotypes revealed a significant association with rs1799983 at both the lumbar spine (P = 0.001) and femoral neck (P = 0.023). Risk association analyses revealed a susceptibility haplotype TTAG which influences the risk of osteoporosis (OR 2.02, 95 % CI 1.05-3.39, P = 0.042) in hypertension after adjusting for the effects of risk factors. Furthermore, this haplotype was significantly associated with BMD at the lumbar spine (P = 0.029) and femoral neck (P = 0.021) in a dose-dependent manner. The results suggest that possession of the TTAG haplotype of the eNOS gene may increase the risk of osteoporosis two-fold in hypertensive postmenopausal women in Northwest India.

Effects of sympatholytic therapy on postmenopausal symptoms in hypertensive postmenopausal women

Objective The short-term effects of two sympatholytic antihypertensive drug treatments, β-blocking agent atenolol and imidazoline receptor-1 agonist moxonidine, on postmenopausal symptoms and their relationship to antihypertensive and insulin sensitivity effect were studied.Design This was a double-blind, prospectively randomized study in a multicenter, multinational setting in 112 hypertensive, overweight, postmenopausal women without hormone therapy.Methods Treatment was either with moxonidine, 0.6 mg/day, or with atenolol, 50 mg/day, for 8 weeks. The main outcome measures were blood pressure, insulin sensitivity by Matsuda sensitivity index and postmenopausal symptoms (hot flushes, palpitations, insomnia, irritability, depression and general impression of the symptoms (GIS) through a questionnaire.Results Both atenolol and moxonidine caused a significant reduction in diastolic blood pressure of 9.5 mmHg and 6.2 mmHg, respectively. The severity of hot flushes and palpitations were reduced significantly in both treatment groups. Relief from hot flushes was recorded in 43% of women taking atenolol and in 27% (not significant between the groups) of moxonidine-treated patients. Palpitations were relieved in 41% and 25% (not significant between the groups) of the women in the atenolol- and moxonidine-treated groups, respectively. In the atenolol group, insomnia and GIS were reduced significantly, with relief of symptoms occurring in 33% and 27% of the patients. A change in irritability was seen in blood pressure responders during the treatment in the atenolol group. There was no correlation between improvement of insulin sensitivity and relief of postmenopausal symptoms.Conclusions In this study, two sympatholytic antihypertensives, atenolol and moxonidine, provided relief from hot flushes and palpitations, and atenolol additionally helped with insomnia and improved GIS.

Aquatic Exercise is as Effective as dry Land Training to Blood Pressure Reduction in Postmenopausal Hypertensive Women

The evidence of the benefits from regular physical activity to hypertensives is based on dry land training studies. Therefore, the aim of this study is to compare the effect of aquatic exercise with dry land training on hypertensive women. This is a randomized controlled study with 52 post-menopausal hypertensive women. The patients were randomly allocated in three groups: water aerobic training group (n = 19), dry land aerobic training group (n = 19) and a non-intervention control group (n = 14). The training protocol was performed by 12 weeks. There were no differences among the three groups concerning basal blood pressure (BP) and biochemical variables. In water group, there was a statistically significant reduction of systolic BP from 136 ± 16 mm Hg at zero week to 124 ± 18 mm Hg at 11th week and 124 ± 15 mm Hg at 12th week. In dry land training group, there was a statistically significant reduction of systolic BP from 138 ± 15 mm Hg at zero week to 125 ± 10 mm Hg at 7th week, 127 ± 10 mm Hg at 10th week and 126 ± 9 mm Hg at 12th week. The control group presented no change in any of the assessed variables. No changes were carried out in any antihypertensive medications during study. This is a randomized controlled study that demonstrates the antihypertensive efficacy of aerobic aquatic exercise.

Abstract 251: 20-HETE Contributes to the Hypertension in a Model of Postmenopausal Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in premenopausal women. PCOS is characterized by hyperandrogenemia that does not abate after menopause. Hyperandrogenemic postmenopausal women (PMW) are hypertensive, but the mechanisms responsible have not been elucidated. Hypertension (HT) in PMW is less well controlled than in age-matched men, which suggests that different mechanisms may be mediating the HT in PMW. We have developed a model, the hyperandrogenemic postcycling female (PMHAF) rat, aged 13-14 mos, that exhibits many of the characteristics found in hyperandrogenemic PMW. In the present study we tested the hypothesis that 20-HETE contributes to the HT in PMHAF rats. Female Sprague-Dawley rats were implanted with dihydrotestosterone (7.5mg/90d) or placebo pellets beginning at 4 wks of age, and pellets were changed every 85 d. At 13-14 mos of age, preglomerular renal microvessels were isolated from PMHAF and placebo control rats (n=6/grp) and 20-HETE and ω-hydroxylase activity were measured by LC-MS. mRNA for CYP4A enzymes were measured by real time RT-PCR. Basal 20-HETE levels in the renal vasculature increased by 60% in PMHAF vs placebo controls (0.398±0.22 vs 0.245 ±0.68 pmol/mg; p&lt;0.05) and 20-HETE synthesis from arachidonic acid was increased by 17-fold (19.6±5.1 vs 1.18±0.14 pmol/min/mg, p&lt;0.001). CYP4A2 mRNA levels were increased 15-fold and CYP4A8 mRNA levels were decreased by 60% in PMHAF rats compared to placebo controls (n=6/grp; p&lt;0.05, PMHAF compared to placebo controls). In another group of rats, acute infusion of an inhibitor of 20-HETE synthesis, HET-0016 (10 mg/kg bolus and 1 mg/kg/h iv) reduced MAP by about 20 mm Hg in PMHAF rats. These data suggest that synthesis of 20-HETE in the vasculature is upregulated in PMHAF rats and contributes to their hypertension. The studies also suggest that novel mechanisms may be responsible for hypertension in PMW with hyperandrogenemia compared to age-matched men, and as such, novel therapeutic approaches may be necessary to control their blood pressures. Supported by PO1HL51971.

Complex use of trimetazidine in postmenopausal hypertensive women with moderate heart failure

Purpose: The objective of this study - comparative assessment of influence of combination of drugs with antihypertensive and metabolic activity on dynamics of structural and functional parameters of left ventricle (LV) remodeling in postmenopausal women with arterial hypertension (AH) and moderate heart failure. Metods: 86 women (age 46-64 years) with blood pressure (BP) >160/100 mm Hg and moderate heart failure (NYHA II-III class) were studied. The patients were divided into 2 groups by 43 in each. Patients of I group received zofenopril 30 mg, amlodipine 5 mg, patients of II group- zofenopril and amlodipine in the same doses plus trimetazidine 70 mg/daily. The echocardiography and Doppler-echocardiography were performed to all of them at baseline and after 12 months of treatment. End systolic volume (ESV), ejection fraction (EF), early diastolic mitral flow velocity/ atrial induced velocity ratio (E/A ratio), isovolumetric relaxation time (IVRT) and blood flow deceleration time (DT) were determined. Results: At the end of the study all patients achieved the goal level of BP<140/90 mm Hg. Regression of LV hypertrophy was observed not in all patients: in 35 patients of I group (81,4%) and 38 patients of II group (88,4%). Moreover decrease of ESV and elevation of EF were observed in both groups, but these changes were more expressed in patients of II group. In II group ESV decreased from 53,6±2,8 ml to 44,1±1.7 ml (p<0,05), in I group: from 52,3±2,4 ml to 45,0±2,1 ml (p<0,05). The elevation of EF in II group (from 40,2±2,8% to 45,8±3,0%) and I group (from 42,1±2,3% to 50,0±2,4%) was statistically non significant in both groups (p<0,05). The improvement of diastolic function was observed in both groups, but the changes were more expressed in patients of II group. E/A ratio increased in patients of II group from 0,95±0,04 to 1,21±0,06 (p<0,05) and from 0,94±0,04 to 1,10±0,03 (p<0.05) – in I group. In patients of II group IVRT decreased from 120,3±6,6 msec to 94,1±4,8 msec (p<0.05), in I group- from 120,8±4,4 msec to 102,2±4,5 msec (p<0,05), at the same time in II group DT decreased from 176,1±11,3 msec to 140,4±10,1 msec (p<0,05). The same index decreased from 174,3±8,8 msec to 150,4±7,1 msec in patients of I group (p<0,05). Conclusion: Results of the study confirm that the hypotensive effect of a combination of an ACE inhibitor (zofenopril) and a calcium antagonist (amlodipine) is followed by regression of left ventricular hypertrophy and improve diastolic function. Adding of trimetazidine to the basic treatment showed a significant improvement in LV diastolic function.

Association of estrogen receptor β gene polymorphisms with hypertension in postmenopausal women

To explore the association between estrogen receptor β (ERβ) gene polymorphisms and hypertension in postmenopausal women. The relationship of two polymorphisms (rs944050 and rs4986938) with hypertension was examined in 71 postmenopausal women with hypertension and 50 healthy age-matched controls. In hypertension and control groups, the ERβ allelic frequencies of A and G were 0.500, 0.500, 0.540, 0.460; 0.077, 0.923, 0.170, 0.830 respectively. The genotypic distributions of both polymorphisms stayed within Hardy-Weinberg equilibrium. For polymorphism rs4986938, statistical difference existed between the wild-type genotype and a combination of heterozygous and homozygous variant genotypes (P < 0.05). The variant allele A of rs4986938 in ERβ gene decreased the risk of hypertension (OR = 0.41, 95%CI 0.18-0.92). The polymorphism rs4986938 in ERβ gene was associated with an elevated risk of hypertension in Chinese Han postmenopausal women.

Positive association between testosterone, blood pressure, and hypertension in women

The association between sex hormones and blood pressure (BP) in women has been investigated mostly in cross-sectional studies yielding inconsistent results. Data from 1428 women from the population-based Study of Health in Pomerania were used. Associations of total testosterone, androstenedione, sex hormone-binding globulin (SHBG), and free testosterone concentrations with BP and hypertension were analyzed in multivariable cross-sectional and longitudinal regression models in the full sample and stratified by menopausal status. A positive association between total testosterone and BP was revealed in the full sample [SBP: β per standard deviation (SD) increase: 3.22; pulse pressure (PP): β per SD increase: 2.30] and among postmenopausal women (DBP: β per SD increase: 3.33; SBP: β per SD increase: 7.11; PP: β per SD increase: 3.77). Longitudinal analyses also showed a positive association between baseline total testosterone and follow-up BP. Furthermore, low total testosterone concentrations were associated with a decreased risk of prevalent hypertension in all women [relative risk (RR) quartile 1 (Q1) vs. Q4, 0.79; 95% confidence interval, CI 0.67-0.94]. Low SHBG was associated with prevalent hypertension in postmenopausal women (RR 1.27; 95% CI 1.06-1.53) and with incident hypertension in the full sample (RR 1.73; 95% CI 1.10-2.75). The present population-based study is the first to show a consistent positive association between total testosterone and BP in both, cross-sectional and longitudinal analyses, suggesting high total testosterone as a risk marker of increased BP, as well as prevalent hypertension in women.

Risk factors for hypertension in a population-based sample of postmenopausal women in Kolkata, West Bengal, India

Hypertension is a major public health problem worldwide. However, limited information is available regarding the risk factors for hypertension in postmenopausal women, particularly in urban populations in developing countries such as India. To investigate whether adiposity measures, serum lipids and lipoproteins as well as fasting plasma glucose can predict the risk of hypertension in a population based sample of postmenopausal women in Kolkata, India, we conducted a cross-sectional study of 415 postmenopausal women (aged 40 to 85), selected by cluster sampling from 12 wards of Kolkata. After multivariate adjustment, apolipoprotein B (apo B) and waist circumference (WC) showed the strongest association with hypertension. The risk of hypertension in the highest tertile compared with the lowest tertile was 2.57 (95% confidence interval = 1.00-6.61) for apo B and 2.55 (95% confidence interval = 1.07-6.06) for WC. Apo B and WC were the strongest risk factors for predicting hypertension among postmenopausal women in Kolkata.

English

BACKGROUND: Elevated Intraocular Pressure (IOP) causes a mechanical stress situation, leading to damage of neurons in retina and their axons resulting in progressive loss of visual field and blindness seen in Glaucoma. Changes in IOP are directly and significantly associated with changes in systemic blood pressures. Blood pressure increases with age in most populations, especially so after menopause. Menopausal women with hypertension are at increased risk of developing elevated IOP. There are limited data about association of moderate changes in blood pressure that often go with treatment for hypertension with IOP. This work was undertaken to study the effect of moderate systemic hypertension on IOP in postmenopausal women. MATERIALS AND METHODS: 40 Normotensive and 40 Hypertensive postmenopausal women participated in the study. All participants satisfied inclusion and exclusion criteria and gave informed consent. Participants underwent detailed clinical and ophthalmologic examination and IOPs were measured using Schiotz Indentation Tonometer. RESULTS: Mean IOP was 15.28+/-2.54 mmHg in normotensive and 19.47+/-3.37 mmHg, in moderately Hypertensive women. IOP was significantly increased (P<0.001**) among the hypertensive post menopausal women compared to normotensives. Subjects with higher SBP had significantly higher IOP (p < 0.001). The mean IOP also showed a significant correlation (p value of 0.001**) to the total number of years after attainment of menopause. CONCLUSIONS: Elevated IOP was seen in postmenopausal women with moderate hypertension associated with treatment. It is therefore essential that postmenopausal hypertensive women are screened regularly for increases in IOP, the only modifiable risk factor for Glaucoma.

Effect of six-week aerobic exercise on Chemerin and Resistin concentration in hypertensive postmenopausal women.

Background:Physical activity reduces symptoms of cardiovascular diseases. The aim of this study was to examine the effect of six-week aerobic exercise upon Chemerin and Resistin concentration in women with menopause who had hypertension.Methods:The population of this quasi-experimental study included postmenopausal women diagnosed with hypertension. They were 50 to 55 years old and lived in Amol, a city in north part of Iran. Twenty volunteers were filled the personal consent and Health Questionnaire. They were randomly assigned to Experimental and control groups equally (n=10 per group). The experimental group conducted a 6-week aerobic training program from 8–10am every day.Results:Endurance exercise decreased Chemerin (t=10.41, P<0.000) and Resistin (t=2.42, P<0.051); indicating the decline of inflammation and cardiovascular disease.Conclusion:Considering anti-inflammatory effects of exercise, training plays an important role in reducing inflammatory indices in human; and endurance training can be a good strategy to deal with inflammation and cardiac- vascular risk factors.

Combination of Echocardiography and Pulse Wave Velocity Provides Clues for the Differentiation between White Coat Hypertension and Hypertension in Postmenopausal Women

Objective: To determine whether or not noninvasive assessment of the cardiovascular system can discriminate white coat hypertension and hypertension in postmenopausal women. The major reason is the high prevalence of white coat hypertension in these subjects and the uncertain associations of white coat hypertension with cardiovascular risk. Patients and Methods: Selected women were required to be naturally or surgically menopausal for at least 1 year but not more than 5 years past their menstrual period. White coat hypertension patients were defined as subjects who had office blood pressures >150/90 mm Hg but who had both systolic and diastolic ambulatory pressures <120/80 mm Hg. In total, 44 subjects with a mean age of 52 years were recruited from the outpatient clinic and examined. Office and home blood pressures were measured using the HEM 401C (Omron Life Science Co. Ltd., Tokyo, Japan), a semi-automatic device that operates on the cuff-oscillometric principle and generates a digital display of the systolic (SBP) and diastolic blood pressure as well as the pulse rate. The pulse wave velocity (PWV) was recorded, and the left ventricular (LV) diameter, septal wall thickness, and left posterior wall thickness were assessed by M-mode echocardiography after selecting the measurement section by B-mode echocardiography. Results: Twenty patients were diagnosed as having white coat hypertension based on the criteria in the trial. Pulse wave patterns were different between subjects with white coat hypertension and those with hypertension. PWV of subjects with white coat hypertension was 1.32 ± 0.33 m/s and that of patients with hypertension was 1.46 ± 0.37 m/s (p < 0.01). In addition to these findings, there was a significant association between the values of home SBP and PWV and the LV mass index. However, this association was not seen for office SBP. When the data of the LV mass index and PWV were combined, white coat hypertension could be easily differentiated from hypertension. Conclusions: The combination of blood pressure self-monitoring, echocardiographic data, and PWV can be a powerful indicator for the treatment of hypertension in postmenopausal women.

Roles played by 20-HETE, angiotensin II and endothelin in mediating the hypertension in aging female spontaneously hypertensive rats

Prevalence of hypertension (HT) increases in women after menopause, and there is evidence that HT is not as well controlled in postmenopausal women as men. The reasons for this are not clear but may be related to the lack of adequate blockade of the systems contributing to HT in women. This study aimed to determine the roles of three of the systems known to contribute to HT in animal studies: angiotensin II (ANG II; enalapril inhibitor), eicosanoids [1-aminobenzotriazole (1-ABT) inhibitor], and endothelin (ET(A) receptor antagonist), on blood pressure (BP) in three groups of female spontaneously hypertensive rats (SHR), aged 18 mos (postmenopausal rat, PMR). After baseline telemetry BP, three drug periods were performed for 5 days each: single blockade (ABT or enalapril), double blockade (ABT+enalapril or enalapril+ABT), and triple blockade (all 3 drugs). Controls received no treatment until the third period when they received ET(A) receptor antagonist alone. Single drug blockade reduced BP in PMR to similar levels. Double blockade reduced mean arterial pressure more in ABT+enalapril rats than in the other group (enalapril+ABT). Triple drug blockade reduced BP to similar levels in both groups, but the BP remained ∼110 mmHg. The data suggest that these three systems, ANG II, eicosanoids, and endothelin, contribute together and independently to BP control in old female SHR. However, other systems also contribute to the HT since the BP was not normalized, supporting the notion that HT in postmenopausal women may require complex multidrug therapy to be better controlled and that may require the development of additional drugs.

Endogenous sex hormones are associated with blood pressure change and hypertension incidence in postmenopausal women

Evaluation of: Wang L, Szklo M, Folsom AR et al. Endogenous sex hormones, blood pressure change, and risk of hypertension in postmenopausal women: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 224(1), 228–234 (2012). Among the mechanisms involved in blood pressure (BP) regulation, sex steroid hormones may play a significant role. Consistently, premenopausal women have a lower incidence of cardiovascular events than postmenopausal women, possibly due to the cardioprotective role of ovarian hormones on both risk factors and vascular health. However, epidemiologic studies investigating the relationships between endogenous sex hormones and BP or hypertension are mainly cross-sectional and gained inconsistent results. The recent prospective study by Wang et al. on 619 postmenopausal women without baseline hypertension from MESA examined the association of endogenous sex hormone levels with subsequent BP change and hypertension status. The main findings are that higher serum concentrations of estra...