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


RESULTS
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.


CONCLUSIONS
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.
Owens
J F
JF
Department of Psychiatry, University of Pittsburgh School of Medicine Pa.
Stoney
C M
CM
Matthews
K A
KA
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D003327:Coronary Disease / Q000209:etiology; D004522:Educational Status; D004837:Epinephrine / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006339:Heart Rate; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008593:Menopause / Q000097:blood / Q000502:physiology* / Q000523:psychology*; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D012307:Risk Factors; D013315:Stress, Psychological / Q000097:blood / Q000503:physiopathology*
D012739:Gonadal Steroid Hormones; D008055:Lipids; D009638:Norepinephrine; D004837:Epinephrine