Hypertensive Postmenopausal Women Research Articles

Effect of Dietary Nitrate on Blood Pressure and Vascular Control in Post‐Menopausal Hypertensive Women

Individuals with hypertension exhibit abnormal pressor responses during rest‐to‐exercise transitions, significantly increasing the likelihood of sudden cardiac events. Dietary nitrate supplementation can lower resting blood pressure in patients with hypertension and improve bulk muscle blood flow in older healthy adults. However, investigations using dietary nitrate as a non‐pharmacological intervention in post‐menopausal women diagnosed with hypertension are lacking. Therefore, the purpose of the current investigation was to determine if acute dietary nitrate supplementation would improve the pressor response to exercise and increase forearm blood flow during steady‐state hand‐grip exercise in post‐menopausal hypertensive women. It was hypothesized that the pressor response to exercise would be attenuated and muscle blood flow would be improved in the nitrate‐rich (NR) versus nitrate‐poor (NP) treatment.METHODSTen hypertensive post‐menopausal women [age 56 ± 3 years (mean±SD); height 165 ± 2 cm; mass 84 ± 13 kg; body mass index 31 ± 5 kg/m2] agreed to participate in the current study. Patients underwent a randomized double‐blind placebo‐controlled trial with a NR or NP beet root juice supplement. Blood samples were taken at the beginning of each testing session (~2 h post ingestion) to determine plasma nitrite levels. Forearm blood flow (FBF) was measured via ultrasonography at the brachial artery of the exercising limb. Beat‐by‐beat blood pressure and heart rate were recorded throughout the trial on the non‐exercising limb. After resting measurements were completed, patients performed hand‐grip exercise at 20% maximal voluntary contraction (MVC) for five minutes to obtain steady‐state blood flow and blood pressure response to exercise.RESULTSPlasma nitrite levels were significantly higher during the NR (809 ± 146 nM) than the NP (79 ± 19 nM) condition. No differences were found between conditions for resting blood flow (NR: 64±2; NP: 62 ± 4 ml min−1; P > 0.05), systolic (NR: 144 ± 2; NP: 145 ± 2 mmHg−1; P > 0.05) or diastolic blood pressure (NR: 78 ± 1; NP: 80 ± 1 mmHg−1; P > 0.05). In addition, there were no significant differences across 10‐second bins (e.g., 0–10, 11–20 seconds) during the first minute pressor response to hand‐grip exercise in either condition (systolic: P > 0.05; diastolic: P > 0.05). As such, the rate pressure product was not significantly different during steady‐state between conditions (NR: 11,562 ± 437; NP: 11,728 ± 437 bpm · mmHg−1; P > 0.05). During steady‐state exercise, FBF (NR: 189 ± 8; NP: 218 ± 8 ml min−1; P = 0.03) and forearm vascular conductance (FVC) (NR: 157 ± 4; NP: 183 ± 4 ml min−1; P = 0.04) were significantly lower during the steady‐state NR condition.CONCLUSIONAcute dietary nitrate supplementation did not improve the pressor response to hand‐grip exercise in hypertensive post‐menopausal women. However, it is important to note that steady‐state FBF (~30 ml min−1) and FVC (~27 ml min mmHg−1) were significantly reduced during the nitrate‐rich condition, which suggests a reduced O2 cost for a given workload because blood flow typically matches metabolic rate.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Prevalence and epidemiological factors associated with hypertension among post-menopausal women in an urban area of central India

BackgroundHypertension is one of the leading cause of global burden of disease. Blood pressure is typically lower in premenopausal women than in their male counterparts. But women loose this advantage after menopause. ObjectivesObjectives of study were to know the prevalence of hypertension among postmenopausal women and to study some of its epidemiological factors. MethodologyIt was a community based cross-sectional study with a sample size of 100 postmenopausal women residing in Kamptee, an urban satellite township of Nagpur district in central India conducted for a period of two months. A written informed consent was taken and a study questionnaire was administered to the participants. Data regarding demographic characteristics, alcohol and tobacco consumption, dietary habits, physical activity, psychological stress and family history was obtained. Physical examination such as waist circumference, hip circumference, weight, height, blood pressure and pulse rate was recorded. Blood pressure was recorded using mercury sphygmomanometer and weight was recorded using standardised electronic weighing machine. ResultsThe prevalence of hypertension in postmenopausal women in the urban area was found to be 33%. The prevalence of isolated systolic hypertension was 30% and that of isolated diastolic blood pressure was 44%. There was significant difference in positive family history of hypertension and body mass index (BMI) between hypertensive and non-hypertensive women. ConclusionThe prevalence of hypertension (33%) among postmenopausal women in Kamptee town was high. There was large burden of risk factors among the study population.

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome: A Prospective, Open-Labeled, Randomized Controlled Trial.

Background:Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.Methods:This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.Results:A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E’; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E’ to the late diastolic mitral annular velocity (E’/A’; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E’ (E/E’; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E’ (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E’/A’ (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E’ (r = 0.472; P = 0.003) and E’/A’ (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E’ (r = −0.590; P < 0.001), E/E’ (r = 0.454; P = 0.004), and E’/A’ (r = −0.377; P = 0.018).Conclusions:Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.Chinese Clinical Trial Register:ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.

Study the Influence of Captopril on Bone Metabolism in Elderly Hypertensive Women

Widespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.&#x0D; Ten elderly hypertensive women age &gt; 60 years old (64.2±3.6) treated with captopril for a 5-6 years ago while they attending Al Yarmouk Teaching Hospital in Baghdad; in addition, newly-diagnosed hypertensives, and normotensive of the aged-matched women were participated in this study that were conducted during the period (January- May 2014). Measurement of serum calcium, magnesium, inorganic phosphorus, total alkaline phosphatase activity, and parathyroid hormone were done, in addition to spine mineral density and t-score of such bone density by dual energy x-ray absorptiometry. The results of this study showed that there were no significant differences in the serum levels of calcium, magnesium, inorganic phosphorus, total alkaline phosphatase activity, and parathyroid hormone in postmenopausal hypertensive women treated for 5-6 years with captopril compared to newly-diagnosed and to aged-matched normotensive women. In addition, non-significant differences were observed in the level of bone mineral density and t score of bone mineral density in all groups of the study. In conclusion, the present study provides additional knowledge concerning the influence of captopril treatment on some selected parameters of bone metabolism in elderly hypertensive women.&#x0D; Keywords: Captopril, Bone metabolism, Elderly women, Hypertension, Dual energy x-ray absorptiometry.

Gender Differences in Epidemiology, Pathophysiology, and Treatment of Hypertension.

This review aims to examine gender differences in both the epidemiology and pathophysiology of hypertension and to explore gender peculiarities on the effects of antihypertensive agents in decreasing BP and CV events. Men and women differ in prevalence, awareness, and control rate of hypertension in an age-dependent manner. Studies suggest that sex hormones changes play a pivotal role in the pathophysiology of hypertension in postmenopausal women. Estrogens influence the vascular system inducing vasodilatation, inhibiting vascular remodeling processes, and modulating the renin-angiotensin aldosterone system and the sympathetic system. This leads to a protective effect on arterial stiffness during reproductive age that is dramatically reversed after menopause. Data on the efficacy of antihypertensive therapy between genders are conflicting, and the underrepresentation of aged women in large clinical trials could influence the results. Therefore, further clinical research is needed to uncover potential gender differences in hypertension to promote the development of a gender-oriented approach to antihypertensive treatment.

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

Left atrium (LA) state reflects the severity of cardiovascular remodeling and indicates the degree of compensation in many cardiovascular diseases, including arterial hypertension (AH). Transthoracic echocardiography determines linear and volumetric parameters of LA, but it has limitations in early stages of AH. Speckle tracking echocardiography is a new technique which can identify early subclinical dysfunction of cardiac chambers. The purpose of the study was 1) to assess feasibility, intra- and inter-observer reproducibility of LA longitudinal strain (LS) derived by both P- and R-wave triggering method; 2) to compare LA strain values obtained by P- and R-wave synchronization in hypertensive postmenopausal women. Material and methods. The study involved 65 post-menopausal hypertensive women (mean age – 56.8 ± 8.15 years). All patients underwent a standard transthoracic and two-dimensional speckle tracking echocardiography using Vivid E9 XDClear Console 4D Expert 100 (GeneralElectric,USA). Apical four- and two-chamber views images were obtained during breath hold with ECG synchronization. All statistical analyses were performed using SPSS 20 for Windows (SPSS, Inc.,Chicago,IL). Results. Initial feasibility of echocardiographic data for performing LA strain analysis was 93.85 %. Adequate tracking quality was achieved in 96.93 % of segments by P-triggering and in 96.35 % by R -wave as initial point of analysis. The intra-class correlation (ICC) coefficient for R-triggering was 0.96 (95 % CI 0.89–0.98) for intra-observer and 0.94 (95 % CI – 0.52–0.97) for inter-observer variability. The ICC coefficients for P-triggering were higher 0.97 (95 % CI 0.92–0.99) and 0.96 (95 % CI – 0.9–0.98), respectively. The Bland-Altman statistic confirmed absence of bias in both variants of ECG-triggering. Values ofLA LS calculated by R-triggering method were significantly higher than those ones by P-triggering (P < 0.001). Conclusions. Speckle tracking echocardiography is a reliable technique, which provides quantitative assessment of LA physiology. The P-wave triggering method of LA strain analysis is more reproducible compared with R-wave triggering variant. TheLA LS values differ significantly depending on ECG-triggering type (P- or R wave), providing higher values by R-wave triggering method.

Breastfeeding and Maternal Hypertension.

Little is known about the relationship between breastfeeding and hypertension. We performed this study to identify whether breastfeeding itself influenced maternal hypertension and whether degree of obesity or insulin sensitivity would contribute to the relationship between breastfeeding and hypertension in postmenopausal women. Our study population comprised 3,119 nonsmoking postmenopausal women aged 50 years or above in the 2010-2011 Korea National Health and Nutrition Examination Survey. We performed logistic regression analyses to examine the relationship between breastfeeding and hypertension and mediation analyses to examine the contributions of obesity and insulin sensitivity to the breastfeeding-hypertension relationship. The odds ratios, with 95% confidence intervals, for hypertension among the highest quintile of number of breastfed children (5-11) and the highest quintile of duration of breastfeeding (96-324 months) were 0.49 (0.31-0.75) and 0.55 (0.37-0.82), respectively, compared to each of lowest quintile groups. The population attributable fractions of hypertension caused by breastfeeding 3 or fewer children and breastfeeding for 56 months or less were 10.2% (P < 0.001) and 6.5% (P = 0.017), respectively. In the mediation analysis, unexpectedly, increased insulin resistance significantly attenuated the protective effect on hypertension of having breastfed more children; additionally, greater obesity and insulin resistance significantly attenuated the protective effects on hypertension of having breastfed for longer. More children breastfed and longer duration of breastfeeding were associated with lower risk of hypertension in postmenopausal women, and degree of obesity and insulin resistance moderated the breastfeeding-hypertension association.

A Study of Anti-hypertensive Drug Prescription Patterns in Hypertensive Post-menopausal women

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Drug prescription in menopause is complex as estrogen deficiency, hypertension (HT) and other risk factors, rapidly increase the risk of cardiovascular diseases (CVD) in post-menopausal women (PMW).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; To evaluate the prescription trends of anti-hypertensive drugs in PMW.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was an observational, cross sectional study conducted over a period of 1 year, on hypertensive PMW. The prescriptions were evaluated for antihypertensive drug use patterns and also as per WHO core drug indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; 21.82% of prescriptions had monotherapy, amongst which angiotensin receptor blockers (ARB) (10%) and individually, telmisartan (5.45%) were most commonly prescribed. Majority of prescriptions had two drug therapy (44.09%), among which ARB + beta-blockers (BB) (20.91%) and individually, Telmisartan + Metoprolol (13.64%) were most frequently prescribed. ARB + Diuretic (DI) (9.55%) was the most common fixed drug combination (FDC) prescribed. ARB + BB + DI (10.45%), ARB + 2DI + BB (4.09%) and ARB + 2DI + BB + Calcium channel blocker (1.82%) were most commonly prescribed three, four and ≥five drug combinations, respectively. Hypolipidemic drugs (60.45%) were maximally co-prescribed. Percentage of drugs prescribed by generic name was 4.63% and from essential drug list was 32.62%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; A high trend of polypharmacy was observed in hypertensive PMW. HT, being a multifactorial disease, deserves a multidisciplinary and a comprehensive approach in the care of this population subgroup. Knowledge of prescription pattern and thus the rational utilisation of drugs will help achieve better control rates of HT and hence curb down the burden of CVDs in PMW.&lt;/p&gt;

The relationship between tooth loss, body mass index, and hypertension in postmenopausal female.

Objective:This study aimed to investigate the relationship between tooth loss and the level of blood pressure with the hypothesis that tooth loss is associated with the increase of hypertension in postmenopausal women.Materials and Methods:Sixty postmenopausal female patients aged 51–68 years were included in the study to assess the relationship between tooth loss and the level of blood pressure. The information including sociodemographics, last menstruation period, hypertension history, and the duration of having tooth loss was recorded. Blood pressure was measured using sphygmomanometer and the number of tooth loss was determined.Results:The results showed a more significant tooth loss in hypertension (median: 23 + 4; interquartile range [IQR]: 6) compared to the normotension postmenopausal women (median: 18 + 6; IQR: 12; P < 0.05). Furthermore, obese patients had more tooth loss (median: 23 + 5; IQR: 8) than the overweight patients (median: 19 + 8; IQR: 8).Conclusion:Tooth loss is associated with the increase of hypertension in postmenopausal women which may have a role in the development of vascular diseases.

Predictors of Hypertension in Post-Menopausal Women in Surakarta, Central Java

Background: Hypertension caused 45% mortality of heart disease and 51% mortality of stroke in 2014. Young women have a lower risk of hypertension than men. The risk increases after menopause due to lower estrogen production. This study aimed to estimate the biopsychosocial factors affecting hypertension in post-menopausal women in Surakarta, Central Java. Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in Surakarta, Central Java, from January to February 2018. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was hypertension. The independent variables were obesity, healthy diet, history of contraceptive use, family support, and family history of hypertension. Data of blood pressure was measured by sphygmomanometer . Other variables were measured by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of hypertensionin post-menopuse women increased with obesity (OR= 13.00; 95% CI=2.99 to 56.51; p=0.001), family history of hypertension (OR=9.99; 95% CI=2.54 to 39.19; p=0.001), and history of hormonal contraceptive use (OR=10.11; 95% CI=2.60 to 39.25; p=0.001). The risk of hypertension in post-menopuse women decreased with healthy diet (OR= 0.16; 95% CI= 0.04 to 0.55; p= 0.004) and strong family support (OR= 0.09; 95% CI=0.19 to 0.39; p=0.001). Conclusion: The risk of hypertension post-menopause women is affected by obesity, family history of hypertension, history of hormonal contraceptive use, healthy diet, and strong family support. Journal of Epidemiology and Public Health (2018), 3(3): 312-322 https://doi.org/10.26911/jepublichealth.2018.03.03.02

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

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

EFFECTS OF CONCURRENT TRAINING ON MORPHOFUNCTIONAL PARAMETERS AND BLOOD PRESSURE IN HYPERTENSIVE WOMEN

Aerobic and resistance exercise have been prescript to prevention and non pharmacological treatment of hypertension. However, there is a lack of studies investigating the effects of concurrent training in hypertensive women. Thus, the aim of this study was to investigate the effects of concurrent training program on rest blood pressure, biochemical variables (blood glucose and total cholesterol) , anthropometric (body mass index and waist circumference) and functional fitness in hypertensive women. Eighteen hypertensive postmenopausal and untrained women (59±12 years old) started in the intervention, but only ten subjects finished. The voluntaries were enrolled in concurrent training, 60 min/day, 3 times a week, during 6 months. Systolic and diastolic blood pressure, blood glucose, total cholesterol, body mass index, waist circumference and functional fitness (AAPHERD) were measured pre and post experimental period. Data were analyzed using the Student’s t test with significance level set at 5% (P?0.05) and Cohen's Effect Size (ES). The results showed significant improvement in systolic and diastolic blood pressure at rest. The other variables did not show significantly changes, but the ES was medium and large for several variables (body mass index, blood glucose, total cholesterol, agility, coordination, aerobic fitness, strength endurance and general functional fitness index). In conclusion, this study confirms that 6 month of concurrent training program improved systolic and diastolic blood pressure in hypertensive women. In addition, the protocol suggests an improvement in anthropometric, biochemical and functional variables related to health.

P6362Omega-3 polyunsaturated fatty acids in hypertensive and normotensive postmenopausal women

P6362Omega-3 polyunsaturated fatty acids in hypertensive and normotensive postmenopausal women

The Effect of Education Self-Care Behaviors on the Hypertension in Postmenopausal Women

The Effect of Education Self-Care Behaviors on the Hypertension in Postmenopausal Women

The effect of relaxation techniques on hypertension secondary to menopause

ContextHypertension after menopause sets women up for an increased risk of negative cardiovascular outcomes. A variety of relaxation techniques exist, which aim to relieve stress and reduce blood pressure. Several studies have been conducted to demonstrate the role of several relaxation techniques in lowering the blood pressure in hypertensive patients.AimThe aim of this study was to determine the effect of relaxation techniques on postmenopausal hypertension.Participants and methodsForty postmenopausal hypertensive women were selected randomly from the outpatient clinic at El Agouza Hospital. They were divided randomly into two groups (A, B): group A was treated with antihypertensive drugs (captopril 25 mg twice daily) and relaxation technique sessions (each session 20 min, three times per week for 3 months), whereas group B was treated with antihypertensive drugs (captopril 25 mg twice daily) only. Blood pressure was evaluated before and after performing the program for both groups. Variables were compared using the unpaired t-test, whereas pairwise comparison (pretreatment vs. post-treatment) within the same group was performed using paired t-test.ResultsGroup A, which was treated with antihypertensive drugs and relaxation techniques, showed a statistically highly significant difference (P<0.01) in both diastolic blood pressure and systolic blood pressure compared with group B, as the mean difference was 12.5 and 3.5, respectively, in the diastolic blood pressure of groups A and B and 15.25 and 6.75 in the systolic blood pressure in groups A and B before and after performing the program, respectively.ConclusionThe practice of relaxation techniques was a very effective method in reducing blood pressure in postmenopausal women.

Hormone replacement therapy has a beneficial effect on hypertensive postmenopausal women: Results from the KNHANES 2010-2012

Hormone replacement therapy has a beneficial effect on hypertensive postmenopausal women: Results from the KNHANES 2010-2012

Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women

BackgroundLong-term exposure to ambient particulate matter (PM) has been previously linked with higher risk of cardiovascular events. This association may be mediated, at least partly, by increasing the risk of incident hypertension, a key determinant of cardiovascular risk. However, whether long-term exposure to PM is associated with incident hypertension remains unclear. MethodsUsing national geostatistical models incorporating geographic covariates and spatial smoothing, we estimated annual average concentrations of residential fine (PM2.5), respirable (PM10), and course (PM10–2.5) fractions of particulate matter among 44,255 post-menopausal women free of hypertension enrolled in the Women's Health Initiative (WHI) clinical trials. We used time-varying Cox proportional hazards models to evaluate the association between long-term average residential pollutant concentrations and incident hypertension, adjusting for potential confounding by sociodemographic factors, medical history, neighborhood socioeconomic measures, WHI study clinical site, clinical trial, and randomization arm. ResultsDuring 298,383 person-years of follow-up, 14,511 participants developed incident hypertension. The adjusted hazard ratios per interquartile range (IQR) increase in PM2.5, PM10, and PM10–2.5 were 1.13 (95% CI: 1.08, 1.17), 1.06 (1.03, 1.10), and 1.01 (95% CI: 0.97, 1.04), respectively. Statistically significant concentration-response relationships were identified for PM2.5 and PM10 fractions. The association between PM2.5 and hypertension was more pronounced among non-white participants and those residing in the Northeastern United States. ConclusionsIn this cohort of post-menopausal women, ambient fine and respirable particulate matter exposures were associated with higher incidence rates of hypertension. These results suggest that particulate matter may be an important modifiable risk factor for hypertension.

Age at First Childbirth and Hypertension in Postmenopausal Women.

Whether age at first childbirth has an effect on hypertension incidence is unclear. The objectives of this study were to examine the relationship between age at first childbirth and hypertension and to examine whether degree of obesity, measured as body mass index, mediates age at first childbirth-related hypertension in postmenopausal women. This study analyzed 4779 postmenopausal women data from the Korea National Health and Nutrition Examination Survey 2010 to 2012. Logistic regression analyses were used to investigate relationship between age at first childbirth and hypertension. Mediation analysis was performed to examine the contribution of body mass index to age at first childbirth-related hypertension. Mean of participants' age at first childbirth and current age were 23.8 and 63.4 years, respectively. The prevalence of hypertension was 51.1%. Age at first childbirth was significantly associated with the prevalence of hypertension (odds ratio, 0.963; 95% confidence interval, 0.930-0.998; P=0.036). Women with age at first childbirth ≤19 years had significantly higher risk of hypertension (odds ratio, 1.61; 95% confidence interval, 1.17-2.23; P=0.004) compared with those >19 years. Multivariable-adjusted prevalence of hypertension was significantly lower in women who delivered the first infant at 20 to 24 (45.5%), 25 to 29 (46.1%), and ≥30 (39.9%) years compared with those at ≤19 years (58.4%). Body mass index completely mediated age at first childbirth-hypertension relationship (indirect effect: odds ratio, 0.992; 95% confidence interval, 0.987-0.998; P=0.008). Age at first childbirth was significantly associated with hypertension in postmenopausal women. Body mass index mediated the effects of age at first childbirth on hypertension.

Hypertension and breast cancer risk: a systematic review and meta-analysis

Observational studies examining the relationship between hypertension and breast cancer risk have reported conflicting findings. We conducted this systematic review and meta-analysis to summarize the evidence regarding the association between hypertension and risk of breast cancer. Eligible studies were identified through a comprehensive literature search of PubMed, EMBASE, and the Cochrane library until August 2016. We included observational studies that reported relative risks (RR) with corresponding 95% confidence intervals (CIs). Results from individual studies were pooled by using a random-effects model. 29 articles of 30 studies, with totally 11643 cases of breast cancer, were eligible for inclusion in the meta-analysis. We observed a statistically significant association between hypertension and increased breast cancer risk (RR: 1.15; 95% CI: 1.08, 1.22). In the subgroup analysis, we found a positive association between hypertension and breast cancer incidence among postmenopausal women (RR: 1.20; 95% CI: 1.09, 1.31). In contrast, hypertension was not associated with risk of breast cancer among premenopausal women (RR: 0.97; 95% CI: 0.84, 1.12) and Asian population (RR: 1.07; 95% CI: 0.94, 1.22).This meta-analysis collectively suggests a significantly association between hypertension and breast cancer risk, specifically for postmenopausal hypertensive women.

Effect of aerobic exercise training on cGMP levels and blood pressure in treated hypertensive postmenopausal women

The second messenger cGMP has been largely studied as a therapeutic target in a variety of disorders such as erectile dysfunction, arterial hypertension and heart failure. Evidence has shown thatcGMP activators are less efficient in estrogen-deficiency animals, but no studies exist involving non-pharmacological approacheson NO/cGMP signaling pathway in hypertensive postmenopausal women. The aim of this study is to examine NO/cGMP pathway, redox state and blood pressure in trained treatedhypertensive (HT) postmenopausal women comparing with normotensive (NT) group. The rationale for that is most of HT patients is encouraged by physician to perform exercise associated with pharmacological treatments.Aerobic exercise training (AET) consisted of 24 sessions, 3 times/week.Parameters were evaluated at baseline and after AET for both groups (HT=28; NT=33).In treatedHT group, AET was significantly effective in increasing cGMP concentrations (28%) accompanied by an up-regulation of SOD (97%) and catalase activity (37%). In NT group, we found an increasein SOD activity (58%). TreatedHT postmenopausal women were still responsive to AET increasing cGMP levels and up-regulating antioxidant system. It should also be emphasized that these findings provide information on the circulating biomarkers that might delay the developing of cardiovascular events in this particular population.