Menopause Review (Feb 2011)
Menopauza jako czynnik ryzyka sercowo-naczyniowego – implikacje terapeutyczne nadciśnienia tętniczego
Abstract
Oestrogen deficiency after the cessation of the ovarian function in women causes many subjective ailmentsas well as serious health problems. In Poland, similarly to other developed countries, cardiovascular diseasesare the main cause of death in women after 50 years of age. Menopause not only induces an increase ofblood pressure, but is also an independent risk factor of cardiovascular complications, especially strokes whenhypertension coexists. The analysis of patients after 64 years of age revealed the prevalence of hypertensionin 81% of women and 66% of men. Hypertension is one of the most important risk factors of coronary arterydisease; in hypertensive women, the risk of development of different cardiovascular complications is 4 timeshigher than in coeval men. Menopause provokes also increased development of atherosclerosis. Cardiovascularrisk factors become more often assessed as the elements of the metabolic syndrome. Some of previous clinicaltrials undermined the positive influence of the treatment of mild hypertension in women because of a lowerrelative risk in this group. The INDANA analysis showed a great absolute benefit of treatment of hypertensionin older women as well as in black people in comparison to men. The decision concerning therapy in younger kobiewomen,especially in Caucasians, has to be made individually depending on the level of the cardiovascularrisk. Diuretics are preferably used in treatment of hypertensive women because of their additional advantage;they have a positive impact on calcium balance that is impaired during menopause. On the other hand, usageof renin-angiotensin-aldosterone system blockers results from the patomechanism of hypertension at themenopausal age and their advantages are revealed in clinical trials.
