The influence of menopause on blood pressure

The association between menopause and systolic and diastolic blood pressure was explored in a random sample of 278 pre- and 184 post-menopausal women. In 64 subjects menopause had been surgically induced. Post-menopausal women had a higher systolic, diastolic and pulse pressure than pre-menopausal subjects (P less than 0.001). Hypertension, defined as being on antihypertensive medication, regardless of BP, or as having a pressure greater than or equal to 140/90 mmHg, was more frequently observed following menopause (40 vs 10%; P less than 0.001). After stratification by age and body mass index, the odds of having hypertension for pre- as compared with post-menopausal women were 2.2 (95% confidence interval from 1.1 to 4.4; P = 0.03). After adjustment of BP for significant covariates, such as body mass index, pulse rate and contraceptive pill intake, the slope of SBP on age was 0.5 mmHg/year (P less than 0.05) steeper in women with natural and surgical menopause than in pre-menopausal subjects. The relation of DBP with age showed a similar slope among pre- and post-menopausal subjects, but in women with natural and surgical menopause taken together, the regression line was shifted upward by an average of 2.3 mmHg (P = 0.03). The relationships of DBP with body mass index and with the urinary sodium: potassium ratio were also 0.2 mmHg/kg/m2 and 0.8 mmHg/unit steeper (P less than 0.05) in post- than in pre-menopausal subjects. In conclusion, in the present cross-sectional study menopause was accompanied by a steeper rise of SBP with age, and by an increase in the absolute level of DBP, which was independent of age.(ABSTRACT TRUNCATED AT 250 WORDS)