# Association Between Serum Follicle‐Stimulating Hormone Levels and Risk of Elevated Blood Pressure and Hypertension Among Postmenopausal Women: A Longitudinal Population‐Based Study

## TL;DR

This study found no link between high follicle-stimulating hormone levels and increased blood pressure or hypertension risk in postmenopausal women.

## Contribution

The study is the first to investigate FSH's longitudinal association with blood pressure outcomes in postmenopausal women using a population-based cohort.

## Key findings

- Baseline FSH levels were not significantly associated with prevalent or incident hypertension or elevated blood pressure.
- Longitudinal blood pressure trajectories were not influenced by baseline FSH levels.
- Despite significant changes in blood pressure over time, FSH levels did not predict these changes.

## Abstract

Postmenopausal‐women experience a rise in follicle‐stimulating hormone (FSH) levels, yet its association with the risk of elevated blood pressure (BP) and hypertension (HTN) remains unclear despite the increased cardiovascular risk in this population. This study first investigated the association between serum FSH levels and both the prevalence and risk of elevated BP and HTN in a long‐term, population‐based cohort of menopausal‐women. Second, we assessed whether FSH levels were associated with longitudinal trajectories of systolic and diastolic blood pressure (SBP and DBP) over time.

Data from 934 post‐menopausal‐women (aged ≥ 40) in the population‐based Tehran Lipid and Glucose were analysed over six phases between 2002 and 2021. Logistic regression assessed the association baseline FSH and prevalent HTN7elevated BP. Cox proportional‐hazards models estimated incident HTN7elevated BP risk. Linear mixed models evaluated SBP and DBP trajectories by FSH level, adjusting for demographic, metabolic, and lifestyle factors.

Among 934 postmenopausal women, mean (SD) age: 58.64 (6.72) years, 43.3% had HTN and 32.8% had elevated BP at baseline. Over 4868 person‐years of follow‐up, 295 women (60.6 per 1000 person‐years) developed HTN, and over 2034 person‐years, 134 (65.9 per 1000 person‐years) developed elevated BP. Baseline FSH levels, whether analyzed categorically or continuously, showed no significant association with the prevalence of HTN (fully‐adjusted OR: 0.87, 95% CI: 0.60–1.27) or elevated BP (fully‐adjusted OR: 0.85, 95% CI: 0.55–1.30), nor with the incidence of HTN (fully‐adjusted HR: 0.975, 95% CI: 0.737–1.288) or elevated BP (fully‐adjusted HR: 1.11, 95% CI: 0.74–1.68). Longitudinal analyses revealed significant changes in SBP and DBP over time, but these trajectories were not influenced by baseline FSH levels.

We found no significant association between baseline serum FSH levels and the prevalence or incidence of elevated BP and HTN, nor with longitudinal changes in systolic or diastolic blood pressure, despite significant BP trajectory changes over the follow‐up period.