Forty women, with hypertension developed during menopause, were divided into two groups, depending on whether from the time of its beginning there were occurrences of clinic episodes expressing a more or less acute "organ damage" or not. In all patients a 24 hrs ambulatory blood pressure monitoring and a carotid ultrasound were carried out to evaluate the carotid intima-media thickness (IMT). The IMT resulted significantly superior in those patients presenting a vascular episode and as much significantly correlated to the pressure values, especially systolic; in particular, in "non dippers" patients there is evidence of correlations between percentages of "at risk" systolic pressure peaks, prevalence of plaques in carotidal vessels and higher IMT compared to those patients with night-time blood pressure decrease. The authors think that the presence of blood pressure values which are persistently, or nearly, high in 24 hrs, especially with wide variations, favours the development of plaques and, in any case, of a higher IMT, all "at risk" elements for acute events. The IMT carotid represents a further easily measurable index with non-invasive method, which can supply a useful evidence of structural alterations in menopause, especially when it is associated with hypertension, and also it represents a predictive evolutive marker for acute cerebro-cardiovascular lesions.

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