Blood pressure and menopausal transition: the Atherosclerosis Risk in Communities study (1987-95)

Objective Blood pressure changes during menopausal transition have not been studied previously using a biracial sample. We invesigated whether menopau sal transition was associated with change in blood pressure in African-Amer ican or white women. Design, setting and participants The prospective multicenter study, the Ath erosclerosis Risk In Communities (ARIC) Study (1987-95) was utilized. Inclu ded were never-users of hormone replacement therapy (3800 women, 44% of the original sample). Main outcome measure Changes in blood pressure were adjusted for baseline a ge and body mass index, baseline blood pressure, antihypertensive use, ARIC field center and weight change. The menopausal transition group was compar ed to the non-transition group, separately, by ethnicity, Results Women undergoing the menopausal transition did not differ significa ntly in regard to systolic blood pressure change [5.2, 95% confidence inter val (CI) 4.0- 6.4] from non-transitional women (4.6, 95% CI 4.0-5.2); adjus tment for age, baseline systolic blood pressure and other factors did not a lter this finding. Transitional women had significantly less diastolic bloo d pressure change (-0.5, 95% CI -1.1 to 0.2) than non-transitional women (- 2.0, 95% CI -2.4 to -1.7, P = 0.000) but, after adjustment for other covari ates, the result was not significant. African-American women had significan tly (P = 0.003) higher systolic blood pressure change compared to white wom en, but this difference became non-significant (P = 0.21) after restricting the sample to women younger than 55 years of age. Interactions between men opausal transition and ethnicity were not significant, either in systolic b lood pressure or diastolic blood pressure change. Conclusion Menopausal transition is not associated with significant blood p ressure change in African-American or white women. J Hypertens 2000, 18:27- 33 (C) Lippincott Williams & Wilkins.