Hypertension, menopause, artery disease risk in the and coronary Women's Ischemia Syndrome Evaluation (WISE) study
Hypertension, menopause, artery disease risk in the and coronary Women's Ischemia Syndrome Evaluation (WISE) study
复制标题
DOI：
10.1016/j.jacc.2005.02.099
复制
发表时间：
2006-02-07
影响因子：
24
通讯作者：
Sopko, G
中科院分区：
文献类型：
--
作者：
Gierach, GL;Johnson, BD;Sopko, G
我们评估了高血压、其他心脏危险因素和冠状动脉疾病（CAD）之间的关系是否受绝经状态和/或年龄的调节。背景年龄与绝经状态在女性CAD发展中的相对作用尚不清楚。方法我们比较了收缩压（SBP）、舒张压（DBP）、脉压（PP）、以及绝经前（n = 123）和绝经后（n = 482）因疑似缺血而接受冠状动脉造影的女性中CAD的传统心脏危险因素。为了评估年龄与绝经状态的相对贡献，我们拟合了一个高血压绝经状态的相互作用项，并调整了age.Results有类似的关系，就传统的冠状动脉危险因素和血管造影CAD在绝经前与绝经后妇女，除了少数例外。20%的绝经前女性患有血管造影CAD，而绝经后女性为31%（p = 0.02）。绝经前妇女的平均（标准差）SBP（132 [25] vs. 139 [20] mm Hg; p < 0.0001）和较低的PP（54 [18] vs. 62 [18] mm Hg; p < 0.0001）与绝经后妇女相比;然而，多变量分析显示，在绝经前，SBP是CAD的危险因素，（p = 0.002），但绝经后妇女（p = 0.13），回归斜率有显著差异（p = 0.04）。这种相互作用效应在年龄调整后仍然存在，表明年龄和绝经状态的独立风险贡献。PP（p = 0.03），但不是为DBP.CONCLUSIONS在妇女进行血管造影怀疑缺血，SBP和PP升高是绝经前妇女的潜在危险因素。结果表明，绝经前妇女高血压的识别需要额外的CAD危险因素评估和管理。
OBJECTIVES We evaluated whether the relationship between hypertension, other cardiac risk factors, and coronary artery disease (CAD) is modulated by menopausal status and/or age.BACKGROUND The relative contribution of age versus menopausal status in the development of CAD in women remains unclear.METHODS We compared systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and traditional cardiac risk factors for CAD in premenopausal (n = 123) and postmenopausal (n = 482) women undergoing coronary angiography for suspected ischemia. To assess the relative contribution of age versus menopausal status, we fit a hypertension menopausal status interaction term and adjusted for age.RESULTS There were similar relationships with regard to traditional coronary risk factors and angiographic CAD in premenopausal versus postmenopausal women, with few exceptions. Twenty percent of premenopausal women had angiographic CAD versus 31% of postmenopausal women (p = 0.02). Premenopausal women had lower mean (standard deviation) SBP (132 [25] vs. 139 [20] mm Hg; p < 0.0001) and lower PP (54 [18] vs. 62 [18] mm Hg; p < 0.0001) compared to postmenopausal women; however, multivariable analyses revealed p I that SBP was a risk factor for CAD in premenopausal (p = 0.002) but not postmenopausal women (p = 0.13), and regression slopes were significantly different (p = 0.04). This interaction effect remained after age adjustment, suggesting independent risk contribution from both age and menopausal status. A similar slope difference was observed for PP (p = 0.03) but not for DBP.CONCLUSIONS Among women undergoing angiography for suspected ischemia, elevated SBP and PP are potent risk factors in premenopausal women. The results suggest that identification of hypertension in premenopausal women dictates additional CAD risk factor assessment and management.