MENOPAUSAL STATUS INFLUENCES AMBULATORY BLOOD-PRESSURE LEVELS AND BLOOD-PRESSURE CHANGES DURING MENTAL STRESS

Background. Frequent and large cardiovascular and neuroendocrine respo nses to psychological stress are thought to enhance an individual's ri sk for cardiovascular diseases. Preliminary data suggest that levels o f reproductive hormones affect the magnitude of stress responses, perh aps contributing to the protective effect of ovarian hormones on preme nopausal women's rates of coronary heart disease. Methods and Results. Healthy middle-aged men and premenopausal and postmenopausal women pe rformed a series of standardized mental and physical challenges while blood pressure, heart rate, plasma catecholamines, lipids, and lipopro teins were measured. Subjects then wore an ambulatory blood pressure m onitor during two consecutive workdays. Results showed that postmenopa usal women had larger mean+/-SEM stress-induced increases in systolic blood pressure (24.7+/-2.2 mm Hg) and diastolic blood pressure (14.3+/ -1.0 mm Hg) compared with either premenopausal women (16.9+/-1.3 and 1 0.2+/-0.9 mm Hg) or men (17.7+/-1.5 and 10.9+/-1.1 mm Hg, respectively ). Postmenopausal women and men had higher mean+/-SEM ambulatory diast olic blood pressure levels (75.5+/-3.2 and 76.4+/-1.8 mm Hg) than did premenopausal women (69.9+/-2.2 mm Hg). Large blood pressure responses during public speaking were associated with high cholesterol levels a nd low educational attainment. Conclusions. Menopause is associated wi th enhanced stress-induced cardiovascular responses and elevated ambul atory blood pressure during the workday. These effects may contribute to the risk of cardiovascular morbidity and mortality after the menopa use.