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Published on: March 1, 2022
[Menopause: Hypertension and vascular disease]
1Sección Hipertensión Arterial, Departamento de Prevención Cardiovascular, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina; Sección Hipertensión arterial, Servicio de cardiología, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina; Facultad de Farmacia y Bioquímica, Cátedra de Fisiología, Universidad de Buenos Aires, UBA, Buenos Aires, Argentina.
Insights
Menopause-related hormone changes increase hypertension risk and cardiovascular disease in women. This review explores the physiopathological mechanisms of postmenopausal hypertension and vascular aging, considering sex-specific drug responses.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Gerontology
Background:
- Hypertension affects 25% of women and is a primary cardiovascular risk factor.
- Menopause-induced hormone changes exacerbate cardiovascular risks, including arterial stiffness, heart failure, and stroke.
- Physiopathological mechanisms of hypertension and cardiovascular disease in menopausal women remain debated.
Purpose of the Study:
- To analyze physiopathological mechanisms of postmenopausal hypertension.
- To understand vascular aging effects in women post-estrogen decline.
- To explore sex-specific differences in antihypertensive drug responses.
Main Methods:
- Literature review of studies on postmenopausal hypertension.
- Analysis of hormonal influences on cardiovascular health.
- Examination of pharmacokinetic and pharmacodynamic variations between sexes.
Main Results:
- Estrogen decline is linked to increased arterial stiffness and cardiovascular disease.
- Women exhibit distinct adverse effects with common antihypertensive medications.
- Vascular aging processes are accelerated by reduced estrogen levels.
Conclusions:
- Understanding postmenopausal hypertension mechanisms is crucial for women's cardiovascular health.
- Tailoring antihypertensive therapies based on sex-specific responses is essential.
- Further research into estrogen's vascular protective role is warranted.
Abstract:
Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system.
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