[Hypertension in postmenopausal women --selected pathomechanisms]

Arterial hypertension is one of the major coronary risk factors for cardiovascular diseases. In women after menopause blood pressure is increased. The mechanisms responsible for the postmenopausal increase in blood pressure are complex and various factors may have some influence on it. A key-role in etiology of postmenopausal hypertension plays a decrease of estrogen production. Hormone replacement therapy in postmenopausal women does not effect significantly blood pressure values. This suggests that the lower level of estrogens is not only one factor in the etiology of hypertension in women in this period. Various elements have been proposed to play a role in etiology of postmenopausal hypertension, such as activation of the sympathetic nervous system, activation of the renin-angiotensin-aldosterone system, endothelium dysfunction, increase in endothelin and oxidative stress, and more common presence of other risk factors for cardiovascular diseases. These include: dyslipidemia, obesity, glucose intolerance and diabetes mellitus type 2, which are correlated with increased risk of cardiovascular complications of arterial hypertension. It is believed that insulin resistance and hyper-insu-linemia provide a link between these disorders and autonomic dysfunction. Many experimental and clinical studies will be necessary to evaluate the importance of the variety of mechanisms described in this review.