title: Changes in hemodynamics and left ventricular structure after menopause.
abstract: 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.
authors.affiliation: University of North Carolina, Chapel Hill, North Carolina 27599-7075, USA. hinderli@med.unc.edu
authors.forename: Alan L
authors.initials: AL
authors.lastname: Hinderliter
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Light
authors.forename: Susan S
authors.initials: SS
authors.lastname: Girdler
authors.forename: Judith
authors.initials: J
authors.lastname: McFetridge
authors.forename: Kristy
authors.initials: K
authors.lastname: Johnson
authors.forename: Robert
authors.initials: R
authors.lastname: Waugh
mesh_terms: 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*