Premenstrual syndrome and risk of subsequent hypertension

经前综合症和随后发生高血压的风险

• 批准号: 8364580
• 负责人: ELIZABETH R BERTONE-JOHNSON
• 金额: $ 19.51万
• 依托单位: UNIVERSITY OF MASSACHUSETTS AMHERST
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8364580
• 关键词: 25-hydroxyvitamin D; Address; Affect; Age; Age of Onset; Alcohol consumption; Behavior Therapy; Behavioral; Biochemical Markers; Blood Pressure; Body mass index; Cardiovascular Diseases; Chronic Disease; Clinical; Clinical Treatment; Clinical Trials; Complex; Contraceptive Usage; Data; Diagnosis; Diastolic blood pressure; Diet; Diet Modification; Disease; Early treatment; Epidemiologic Studies; Etiology; Fluid Balance; Functional disorder; Health; High Risk Woman; Hormonal; Hypertension; Incidence; K-Series Research Career Programs; Knowledge; Lead; Life; Life Cycle Stages; Luteal Phase; Menstrual cycle; Morbidity - disease rate; Nurses' Health Study; Obesity; Oral Contraceptives; Outcome; Participant; Pattern; Plasma; Population; Premenopause; Premenstrual syndrome; Prevalence; Principal Investigator; Prospective Studies; Quality of life; Renin-Angiotensin-Aldosterone System; Risk; Risk Factors; Screening procedure; Sentinel; Smoking; Symptoms; System; Teenagers; Time; Variant; Vitamin D; Woman; Work; cardiovascular disorder risk; cohort; comparison group; cost effective; disorder risk; effective therapy; experience; high risk; improved; meetings; novel; novel strategies; prevent; prospective; reproductive; young adult; young woman

DESCRIPTION (provided by applicant): Hypertension is one of the strongest predictors of cardiovascular disease (CVD) in women. Despite extensive knowledge of the etiology of hypertension and the availability of effective treatments, prevalence remains high. There is a substantial need for novel strategies to identify premenopausal women at high risk for hypertension who would benefit from early intervention to reduce their long term risk of CVD. Up to 20% of premenopausal women meet clinical criteria for premenstrual syndrome (PMS), a disorder characterized by moderate to severe luteal phase symptoms that substantially interfere with normal life activities and interpersonal relationships. The pathophysiology of PMS is complex, and factors including dysfunction of the renin-angiotensin-aldosterone system and vitamin D insufficiency likely contribute. Importantly, these factors have also been implicated in the etiology of hypertension. Thus, moderate to severe PMS may be predictive of increased risk of hypertension later in life, and may serve as an early sentinel of CVD risk. The proposed project will extend work completed during the Principal Investigator's current career development award (K01MH07624) to explore the relation of PMS with hypertension and blood pressure in two populations of women. First, we will determine prospectively if PMS occurring in the middle reproductive years is associated with subsequent risk of hypertension and changes in blood pressure over time. We have developed a prospective study of PMS nested within the Nurses' Health Study II (NHS2) cohort; to our knowledge, this is the only prospective epidemiologic study of women with PMS in existence. The NHS2 PMS Sub-Study includes 1257 women meeting established criteria for moderate to severe PMS and a comparison group of 2463 women without PMS. As of 2013, participants will have been followed for 24 years for incident hypertension and changes in blood pressure, and women with PMS will have been observed for up to 20 years following their PMS diagnosis. Second, we will determine if common PMS treatments and dietary and behavioral factors modify the association of PMS and blood pressure, and thus may provide opportunities for women experiencing PMS to reduce their risk of hypertension and CVD. Finally, using data from a second study of young adult women (n=375), we will determine if differences in blood pressure are already evident in women experiencing PMS in their late teens and early 20's. Data from both studies have already been collected, thus providing a cost- effective way to address these novel and important questions. IMPACT: This life course study will be the first to evaluate whether moderate to severe PMS may serve as an early sentinel of long-term health outcomes. It may help identify a population of women at high risk for hypertension who would benefit from increased screening and early intervention. Furthermore, it may lead to clinical trials of novels strategies for treating PMS, no only to reduce morbidity and improve quality of life in women with the disorder, but also to reduce their long-term risk of cardiovascular disease. PUBLIC HEALTH RELEVANCE: Hypertension is among the strongest predictors of cardiovascular disease in women, but despite extensive knowledge of its causes and the availability of effective treatments, the prevalence of hypertension remains high. The proposed project will determine if women experiencing moderate to severe premenstrual syndrome (PMS) are at higher risk of subsequently developing hypertension, and thus whether PMS may be an early sentinel of cardiovascular disease risk. This unique study will be the first prospective assessment of the relation of PMS and blood pressure, and may help identify women who would benefit from increased screening and early intervention to prevent hypertension and lower risk of cardiovascular disease.

描述（由申请人提供）：高血压是女性心血管疾病 (CVD) 最强的预测因素之一。尽管人们对高血压的病因有广泛的了解并且有有效的治疗方法，但患病率仍然很高。迫切需要新的策略来识别患有高血压高风险的绝经前女性，她们可以从早期干预中受益，以降低她们患心血管疾病的长期风险。高达 20% 的绝经前女性符合经前综合症 (PMS) 的临床标准，这是一种以中度至重度黄体期症状为特征的疾病，严重干扰正常生活活动和人际关系。 PMS 的病理生理学很复杂，可能与肾素-血管紧张素-醛固酮系统功能障碍和维生素 D 不足等因素有关。重要的是，这些因素也与高血压的病因有关。因此，中度至重度经前综合症可能预示着晚年高血压风险增加，并可能作为心血管疾病风险的早期哨兵。拟议的项目将扩展首席研究员当前职业发展奖（K01MH07624）期间完成的工作，以探索经前综合症与高血压和两个女性群体血压的关系。首先，我们将前瞻性地确定在生育中期发生的经前综合症是否与随后的高血压风险和血压随时间的变化有关。我们在护士健康研究 II (NHS2) 队列中开展了一项针对经前综合症的前瞻性研究；据我们所知，这是现有的唯一针对经前综合症女性的前瞻性流行病学研究。 NHS2 PMS 子研究包括 1257 名符合中度至重度 PMS 既定标准的女性，以及由 2463 名没有 PMS 的女性组成的对照组。截至 2013 年，参与者将接受为期 24 年的高血压事件和血压变化跟踪，患有经前综合症的女性将在诊断出经前综合症后接受长达 20 年的观察。其次，我们将确定常见的经前综合症治疗以及饮食和行为因素是否会改变经前综合症与血压的关联，从而可能为经历经前综合症的女性提供降低高血压和心血管疾病风险的机会。最后，利用对年轻成年女性 (n=375) 进行的第二项研究的数据，我们将确定在十几岁和 20 岁出头经历经前综合症的女性中血压差异是否已经很明显。这两项研究的数据已经收集完毕，从而为解决这些新颖而重要的问题提供了一种经济有效的方法。影响：这项生命历程研究将首次评估中度至重度经前综合症是否可以作为长期健康结果的早期哨兵。它可能有助于确定高血压高危女性人群，这些女性将受益于加强筛查和早期干预。此外，它可能会导致治疗经前综合症的新策略的临床试验，不仅可以降低患有这种疾病的女性的发病率并提高生活质量，还可以降低她们患心血管疾病的长期风险。 公共卫生相关性：高血压是女性心血管疾病最强的预测因素之一，但尽管人们对其病因有广泛的了解并且有有效的治疗方法，但高血压的患病率仍然很高。拟议的项目将确定患有中度至重度经前综合症 (PMS) 的女性随后患高血压的风险是否较高，从而确定 PMS 是否可能是心血管疾病风险的早期哨兵。这项独特的研究将是对经前综合症和血压关系的首次前瞻性评估，可能有助于确定哪些女性可以从加强筛查和早期干预中受益，以预防高血压和降低心血管疾病的风险。