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Blood Pressure Changes During Aging and Menopause Among Forager-Horticulturalists in the Bolivian Amazon
M J Getz1,2,3, T Cao4, J E Aronoff1
1Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, USA.
Insights
Menopause impacts blood pressure similarly across diverse populations, with systolic pressure rising and diastolic pressure falling postmenopause. However, differing cardiovascular disease risk environments before menopause may influence later health outcomes.
Area of Science:
- Reproductive Health
- Cardiovascular Health
- Anthropology
Background:
- Cardiovascular disease (CVD) is a leading cause of death in women globally.
- Menopause is linked to increased CVD morbidity and mortality, but its precise impact on blood pressure is not fully understood.
- Existing evidence on menopause and blood pressure is primarily from industrialized populations, necessitating broader research.
Purpose of the Study:
- To investigate the association between menopause, blood pressure, and hypertension in Tsimane forager-horticulturalists.
- To compare these associations with a nationally representative US sample to identify population-level differences.
- To explore the role of estradiol in mediating blood pressure changes during menopause.
Main Methods:
- Analysis of data from Tsimane individuals (n=5,570) and US NHANES participants (n=6,861).
- Linear regression models were used to assess age and population effects on systolic blood pressure (SBP) and diastolic blood pressure (DBP) concerning menopause.
- Logistic regression models examined hypertension, and mediation analyses investigated estradiol's role.
Main Results:
- Postmenopause was associated with higher SBP trajectories (b=0.002, p<0.001) and lower DBP trajectories (b=-0.004, p<0.001).
- Tsimane women exhibited faster SBP increases with age compared to US women (b=0.001, p=0.021), while their DBP decreased less dramatically (b=0.003, p<0.001).
- Individuals postmenopause had lower odds of hypertension with age than premenopausal women; estradiol did not mediate blood pressure effects.
Conclusions:
- Menopause-associated blood pressure changes appear consistent across populations with different CVD risk environments.
- Tsimane women experienced distinct age-related blood pressure shifts postmenopause compared to US women.
- While menopause's effect on blood pressure may be universal, premenopausal CVD risk factors could influence postmenopause cardiovascular health outcomes.
Objectives:
Cardiovascular disease (CVD) is the leading cause of death for women globally, and menopause is associated with elevated morbidity and mortality. The total impact of menopause on blood pressure remains inconclusive, with evidence largely based on data from industrialized populations. To address this gap, we examined associations between menopause, blood pressure, and hypertension among Tsimane forager-horticulturalists and compared results against a nationally representative US sample to assess population-level differences in blood pressure with menopause.
Materials And Methods:
We analyzed data from female and male Tsimane (nindividuals = 5,570; nobservations = 18,676; ages 15-92) and US National Health and Nutrition Examination Survey participants (NHANES; nindividuals = 6,861; ages 16-80). We applied linear regression models to assess age and population effects on systolic (SBP) and diastolic blood pressure (DBP) with menopause, logistic regression models for hypertension and stage 2 hypertension, and mediation analyses with estradiol.
Results:
SBP age trajectories were higher (b = 0.002, p < 0.001) and DBP trajectories lower (b = -0.004, p < 0.001) following menopause. Compared to US women, Tsimane women's SBP increased more quickly with age (b = 0.001, p = 0.021), while DBP decreased less dramatically (b = 0.003, p < 0.001). Postmenopause individuals had lower odds of hypertension with age compared to premenopausal women. Estradiol did not mediate blood pressure effects of menopause.
Discussion:
We found similar associations between menopause and blood pressure in both populations, despite widely differing CVD risk environments. However, Tsimane women showed slightly different pressure changes with age postmenopause. These results indicate blood pressure change postmenopause may be universal, but premenopause CVD risk environments may impact postmenopause CVD risk outcomes.
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