Background: The relationship between menopause and hypertension has been a topic of investigation for several years. In the pathogenesis of hypertension after menopause, metabolic disturbances play an important role.
Aim: To assess the relationship between adipocytokines and blood pressure, lipid and glucose metabolism in middle-aged perimenopausal women with essential hypertension.
Methods: The study included 192 women aged 40 to 60 years (mean age 51.73 +/- 1.82 years), 152 with mild and moderate essential hypertension and 40 normotensive age-matched controls. The diagnosis of menopause was based on the data from medical records and confirmed by serum concentrations of the FSH. The study population was stratified according to the menopausal status into four subgroups (normotensive pre- and postmenopausal, and hypertensive pre- and postmenopausal patients). In all subjects anthropometrical measurements and 24-hour ambulatory blood pressure monitoring were performed. Serum levels of leptin, adiponectin and resistin were measured using immunochemical assays. Fasting blood samples were taken for glucose, insulin and serum lipids concentration.
Results: Postmenopausal women did not differ from premenopausal in respect to mean arterial pressure (normotensive 85.2 +/- +/- 5.6 vs 84.4 +/- 4.9 mm Hg; hypertensive 99.5 +/- 5.9 vs 98.8 +/- 5.3 mm Hg). Menopause had no effects on glucose metabolism. Total cholesterol and LDL cholesterol were significantly higher in postmenopausal women. In multiple regression analysis, the strongest predictors of hypertension were waist circumference and serum leptin concentration. Adiponectin and resistin levels were not associated with blood pressure values.
Conclusions: In hypertensive postmenopausal females increased leptin level may play an important role in the pathogenesis of hypertension, independent of body mass index. Menopause per se does not affect blood pressure values. The influence of menopause on serum lipids may modulate the cardiovascular risk profile in postmenopausal females.
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