A. Scuteri et al., Hormone replacement therapy and longitudinal changes in blood pressure in postmenopausal women, ANN INT MED, 135(4), 2001, pp. 229-238
Citations number
47
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: The incidence of hypertension in postmenopausal women exceeds t
hat in age-matched men. Longitudinal studies relating hormone replacement t
herapy (HRT) to blood pressure changes are sparse.
Objective: To investigate the association between HRT and longitudinal chan
ges In blood pressure In postmenopausal women.
Design: Longitudinal observational study.
Setting: Community-dwelling volunteers.
Patients: 226 healthy, normotensive postmenopausal women from the Baltimore
Longitudinal Study of Aging with a mean (+/- SD) age of 64 +/- 10 years we
re followed for 5.7 +/- 5.3 years. Seventy-seven women used both estrogen a
nd progestin, and 149 used neither.
Measurements: Lifestyle variables, blood pressure, and traditional cardiova
scular risk factors were measured at baseline and approximately every 2 yea
rs thereafter.
Results: Systolic blood pressure at baseline was similar in HRT users and n
onusers (133.9 +/- 16.0 mm Hg vs. 132.4 +/- 14.8 mm Hg). Over time, average
systolic blood pressure increased less in HRT users than nonusers, indepen
dent of other cardiovascular risk factors, physical activity, and alcohol u
se. For example, HRT users who were 55 years of age at their first Baltimor
e Longitudinal Study of Aging visit experienced a 7.6-mm Hg average increas
e in systolic blood pressure over 10 years; in contrast, the average increa
se in nonusers was 18.7 mm Hg. The lesser increase in systolic blood pressu
re in HRT users was more evident at older age. Diastolic blood pressure, wh
ich did not change statistically over time in either group, was not associa
ted with HRT.
Conclusion: Postmenopausal women taking HRT have a smaller increase in syst
olic blood pressure over time than those not taking HRT. This difference is
intensified at older ages.