Abnormal sonographic endometrial findings in asymptomatic postmenopausal women: Possible role of antihypertensive drugs

Objective: The purpose of this study was to evaluate the possible effect of the antihypertensive agent nifedipine (a calcium channel antagonist) on th e endometrium of asymptomatic menopausal women by using transvaginal sonogr aphy, hysteroscopy, and endometrial sampling. Design: Eighty-five asymptomatic postmenopausal women with an ultrasonograp hically detected endometrial thickness of more than 7 mm were examined. The study group comprised 43 women treated with nifedipine (30-60 mg/day) for mild to moderate hypertension for at least 1 year, and the control group co mprised 42 normotensive women. All participants underwent transvaginal sono graphy, hysteroscopy, and, if necessary, endometrial biopsy. Results: Of the 85 patients, 53 were found to have atrophic endometrium, 36 (83.7%) in the study group and 17 (40.5%) in the control group. The differ ence between the groups was statistically significant (p < 0.05). There wer e three cases of hyperplasia and three cases of carcinoma of the endometriu m, with similar rates in the two groups. Conclusions: Among asymptomatic postmenopausal patients with sonographicall y thickened endometrium, atrophic endometrium was found to be significantly more prevalent in those using calcium channel antagonists to control hyper tension than in those who were normotensive controls. The presence of endom etrial hyperplasia and malignancy in the study group underscores the import ance of meticulous endometrial evaluation whenever sonographically thickene d endometrium is encountered. (Menopause 1998;5:223-225. (C) 1998, The Nort h American Menopause Society.).