AMBULATORY BLOOD-PRESSURE CHANGES IN THE MENSTRUAL-CYCLE OF HYPERTENSIVE WOMEN - SIGNIFICANCE OF PLASMA-RENIN ACTIVITY VALUES

Blood pressure (BP) changes during the menstrual cycle (MC) have not b een studied in hypertensive women in relationship to changes in sex ho rmone levels and plasma renin activity (PRA). We therefore carried out 24 h ambulatory BP recordings and hormonal measurements in 34 hyperte nsive and 27 matched normotensive women during the follicular ovulator y and luteal phases of the menstrual cycle. Plasma renin activity was similar in the two groups and rose significantly during the luteal pha se only in the hypertensives (P < .01). There were no differences in p lasma estradiol or progesterone between the normotensives and hyperten sives, but testosterone was higher in the hypertensives during the ovu latory (P < .01) and luteal (P < .001) phases. Blood pressure did not change in the normotensives throughout the cycle, but it increased in the hypertensives during ovulation (P < .01). When patients were divid ed according to mean menstrual cycle PRA, only those with relatively l ow PRA (< 2 ng/mL/h) had a significant BP rise during ovulation and it primarily occurred at night (P < .05). The results demonstrate that p remenopausal hypertensive women have increased testosterone during ovu lation and increased testosterone and PRA during the luteal phase of t he cycle. Like normotensives, hypertensives with relatively high PRA e xhibit no change in BP during the cycle, whereas those with relatively low PRA have a nighttime increase in BP during ovulation.