CONVENTIONAL AND AMBULATORY BLOOD-PRESSURE AND MENOPAUSE IN A PROSPECTIVE POPULATION STUDY

Whether menopause would be associated with a rise in blood pressure (B P) was prospectively assessed in a cohort study. A total of 315 women (30-70 years at follow-up) were randomly selected from the population. They were matched on age and rank of body mass index with 315 men. Fi ve BP readings were obtained by conventional sphygmomanometry (CBP) at the subjects' homes on each of two baseline visits and at one followu p visit. The 24-h ambulatory BP was recorded at follow-up. Menstrual s tatus was assessed by questionnaire. The statistical tests were two-si ded and accounted for age, body mass index, antihypertensive treatment , contraceptive pill intake or changes in these variables. From baseli ne to follow-up (median, 5.2 years), 166 and 105 women stayed pre-or p ostmenopausal, while menses ceased in 44 perimenopausal women. In cros s-sectional analyses, the postmenopausal women, compared with their pr e-and perimenopausal counterparts, had a 4-5 mmHg higher systolic cap (15 readings per subject) and 24-h BP (P less than or equal to 0.05 fo r differences between peri- and postmenopausal women). Furthermore, sy stolic cap rose nearly 5 mmHg per decade more (P less than or equal to 0.05) in peri- and postmenopausal women than in premenopausal subject s. In addition, the longitudinal results showed that systolic CBP did not change in women who stayed premenopausal throughout followup (P = 0.71), but increased by approximately 4 mm Hg over 5 years in peri-(P= 0.07) and postmenopausal (P=0.01) subjects (P= 0.02 for difference bet ween pre- and postmenopausal women). Such trends were not observed for diastolic BP in women or for systolic and diastolic BP in men. In con clusion, menopause per se may potentiate the age-related increase in s ystolic pressure. Because confined to systolic pressure, this specific effect of menopause may be mediated via a reduction in arterial compl iance.