Blood pressure and metabolic profile after surgical menopause: comparison with fertile and naturally-menopausal women

In 1978 a random sample (367 men and 568 women aged 18-65 years) taken from the general population of a north-eastern Italian town was screened for ca rdiovascular risk; 16 years later, the women were invited to a second scree ning. Three groups were identified at the initial screening (fertile, natur ally menopausal and surgically menopausal) and four in the longitudinal stu dy (137 remained fertile during the whole study, 205 became naturally menop ausal, 56 were ovariectomised and 127 were already going through the menopa use). The protocol included a questionnaire, blood pressure (BP) measuremen t, and blood exams. Continuous variables were adjusted for confounders. Sys tolic BP, prevalence of hypertension, cholesterol, glycaemia and uricaemia were similar, whereas diastolic and triglycerides (TG) were lower in surgic ally-menopausal than in fertile women (P < 0.001), No significant differenc e in 16 years' variation from baseline was observed between the four groups , although women who remained fertile showed the smallest increases. In par ticular, neither systolic or diastolic BP increases differed between the wo men who were oophorectimised and those who remained fertile, 'Fertile statu s' was rejected from the logistic equation of incidence of hypertension, an d 'age of menopause' was also rejected when this analysis was repeated in o variectomised women. New coronary artery disease (angina pectoris or myocar dial infarction) was observed in one ovariectomised woman, in three natural ly menopausal, and in 13 already menopausal women which seemed to reflect t he age trend. No new cases were observed in women who remained fertile. In conclusion, in Italian women surgical menopause, similarly to natural menop ause, is devoid of any negative prognostic effect.