Abstract

Menopause is an inevitable physiological phenomenon in which cardiovascular risk factor (CRF) factors association is reported, but age at menopause (AAM) varies considerably and could affect the risk among postmenopausal women. The aim of the study was to clarify whether AAM is associated with hypertension, independent of chronological age, lifestyle and hormone replacement therapy (HRT), in Nepalese women. Premenopausal women (pre-MW) have lower blood pressure (BP) than age-matched men, and women have higher rates of hypertension than men as they age.1 These findings suggest that gender or sex hormones have a prominent role in hypertension. Determining the role of sex hormones in the pathogenesis or progression of hypertension is complex given the effects of aging on the cardiovascular system and its relationship to other powerful risk factors such as body weight and cholesterol level.2 Longitudinal and cross-sectional studies report conflicting results concerning the role of menopause in the pathogenesis of hypertension. Large randomized trials of hormone replacement therapy (HRT) have called into question the long assumed protective effect of estrogen in heart disease risk.3,4 There are excellent reviews on the effects of gender and sex hormones on vascular tone and pathophysiologic abnormalities associated with hypertension in animals.5,6 This review focuses on studies in postmenopausal women (PMW), the relationship between menopause and hypertension, factors contributing to hypertension in PMW, and discussion of identification and treatment of hypertension in PMW. Post-menopausal women (Post-MW) are at increased risk of CVD and the prevalence of hypertension in women increases when they reach menopause. Indeed, until 45 years of age, the prevalence of hypertension tends to be lower in women than in men.