Changes in hemodynamics and left ventricular structure after menopause.
To evaluate the cardiovascular changes associated with menopause, we studied hemodynamics at rest, ambulatory blood pressure, and left ventricular structure in a biracial cohort of pre- and postmenopausal women of similar age, race, weight, and blood pressure. Despite similar levels of blood pressure, postmenopausal women had a higher indexed peripheral resistance (2,722 +/- 757 vs 2,262 +/- 661 dynes.s.m(2)/cm(5), p <0.01) and a lower cardiac index (2.64 +/- 0.73 vs 3.10 +/- 0.71 L/min.m(2), p <0.01) than premenopausal women. Postmenopausal women also had less nocturnal decreases in both systolic (15 +/- 8 vs 19 +/- 8 mm Hg, p <0.01) and diastolic (12 +/- 6 vs 15 +/- 6 mm Hg, p = 0.05) pressures during ambulatory monitoring and higher levels of hematocrit (40 +/- 2% vs 38 +/- 3%, p <0.01). In association with this greater hemodynamic load, postmenopausal women had evidence of early concentric left ventricular remodeling, manifested by a greater relative wall thickness (0.38 +/- 0.06 vs 0.35 +/- 0.06, p <0.01) than that observed in premenopausal women. Differences between pre- and postmenopausal women in hemodynamics, diurnal blood pressure variation, and left ventricular structure were observed in white and African-American subjects. These results suggest that menopause is associated with hemodynamic changes and left ventricular remodeling, which may contribute to the enhanced cardiovascular risk observed in postmenopausal women.
Hinderliter
Alan L
AL
University of North Carolina, Chapel Hill, North Carolina 27599-7075, USA. hinderli@med.unc.edu
Sherwood
Andrew
A
Blumenthal
James A
JA
Light
Kathleen C
KC
Girdler
Susan S
SS
McFetridge
Judith
J
Johnson
Kristy
K
Waugh
Robert
R
D001741:Black or African American / Q000706:statistics & numerical data*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D017698:Postmenopause; D017697:Premenopause; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*