Menopausal status influences ambulatory blood pressure levels and blood pressure changes during mental stress

• Published in: Circulation (New York, N.Y.) Vol. 88; no. 6; pp. 2794 - 2802
• Main Authors: OWENS, J. F, STONEY, C. M, MATTHEWS, K. A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.12.1993
• Subjects: Adult; Biological and medical sciences; Blood Pressure - physiology; Coronary Disease - etiology; Educational Status; Epinephrine - blood; Female; Fundamental and applied biological sciences. Psychology; Gonadal Steroid Hormones - blood; Heart Rate; Hemodynamics. Rheology; Humans; Lipids - blood; Male; Menopause - blood; Menopause - physiology; Menopause - psychology; Middle Aged; Norepinephrine - blood; Risk Factors; Stress, Psychological - blood; Stress, Psychological - physiopathology; Vertebrates: cardiovascular system; Human; Menopause; Exploration; Arterial pressure; Ambulatory; Circulatory system; Hemodynamics; Monitoring; Stress
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.88.6.2794

Frequent and large cardiovascular and neuroendocrine responses to psychological stress are thought to enhance an individual's risk for cardiovascular diseases. Preliminary data suggest that levels of reproductive hormones affect the magnitude of stress responses, perhaps contributing to the protective effect of ovarian hormones on premenopausal women's rates of coronary heart disease. Healthy middle-aged men and premenopausal and postmenopausal women performed a series of standardized mental and physical challenges while blood pressure, heart rate, plasma catecholamines, lipids, and lipoproteins were measured. Subjects then wore an ambulatory blood pressure monitor during two consecutive workdays. Results showed that postmenopausal women had larger mean +/- SEM stress-induced increases in systolic blood pressure (24.7 +/- 2.2 mm Hg) and diastolic blood pressure (14.3 +/- 1.0 mm Hg) compared with either premenopausal women (16.9 +/- 1.3 and 10.2 +/- 0.9 mm Hg) or men (17.7 +/- 1.5 and 10.9 +/- 1.1 mm Hg, respectively). Postmenopausal women and men had higher mean +/- SEM ambulatory diastolic blood pressure levels (75.5 +/- 3.2 and 76.4 +/- 1.8 mm Hg) than did premenopausal women (69.9 +/- 2.2 mm Hg). Large blood pressure responses during public speaking were associated with high cholesterol levels and low educational attainment. Menopause is associated with enhanced stress-induced cardiovascular responses and elevated ambulatory blood pressure during the workday. These effects may contribute to the risk of cardiovascular morbidity and mortality after the menopause.