# Correlation between ambulatory blood pressure indices and sex hormone imbalance in hypertensive women with different menopausal durations: a cross-sectional study

## TL;DR

This study explores how sex hormone imbalances in postmenopausal women with hypertension are linked to blood pressure patterns, particularly at night.

## Contribution

The study identifies specific hormone ratios associated with ambulatory blood pressure indices in hypertensive women based on their menopausal duration.

## Key findings

- In women within 5 years of menopause, T/PRL–E2 is associated with nighttime systolic blood pressure.
- For women 6–10 years postmenopause, the PRL/FSH ratio is negatively correlated with nighttime systolic blood pressure.
- The FSH/PRL ratio shows protective associations with diastolic blood pressure in women with menopausal durations of less than 5 years and 11–15 years.

## Abstract

The prevalence of hypertension in postmenopausal women increases significantly compared to premenopausal women and gradually catches up with, or even exceeds, that of their male counterparts. Imbalanced levels of sex hormones play a critical role in the elevation of blood pressure (BP) observed in this population. Furthermore, blunted nocturnal BP decline is a key factor contributing to their increased cardiovascular risk. This study compared ambulatory blood pressure (ABP) values between female hypertensive patients with different menopausal durations and matched male patients, aiming to explore the correlation between sex hormone imbalance and ABP values.

This cross-sectional study included 210 postmenopausal women and 210 matched male patients. The male patients were matched to hypertensive female patients with varying menopausal durations on the basis of variables such as age, body mass index (BMI, kg/m2), hypertension duration, antihypertensive medication use and metabolism-related indicators. Clinical characteristics, Ambulatory Blood Pressure Monitoring (ABPM), and sex hormone levels were evaluated. Quantitative data were analyzed using one-way analysis of variance and multiple regression analysis.

Compared with matched men, in women with hypertension within 5 years after menopause, the T/PRL–E2 was associated with nighttime SBP. In those with menopausal durations of 6–10 years, the FSH/T ratio is associated with the absence of significant differences in 24-h SBP and daytime SBP relative to matched men, while the PRL/FSH ratio is negatively correlated with nighttime SBP in this group. In hypertensive women with menopausal durations of 11–15 years, the PRL-E2/T ratio is linked to 24-h, daytime and nighttime SBPs. In contrast, correlations involving diastolic blood pressure (DBP) indices displayed a distinct pattern. The FSH/PRL ratio shows a protective association with all mean DBP parameters in hypertensive women with menopausal durations less than 5 years and 11–15 years, whereas the T/P ratio is positively associated with those with 6–10 years of menopause.

There was a significant correlation between sex hormone levels and ABP parameters, particularly nocturnal SBP, in women with different menopausal durations.

Trial registration: This study was retrospectively registered on ClinicalTrials.gov (NCT03451747) on February 18, 2018.