A Single Pill to Treat Postmenopausal Hypertension? Not Yet

Yanes, Licy L.; Romero, Damián G.; Iliescu, Radu; Reckelhoff, Jane F.

doi:10.2174/156802611796117667

Cited by 10 publications

(4 citation statements)

References 56 publications

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“…Estrogen loss suppresses estrogen-receptor dependent mechanisms that regulate vascular tone through processes like endothelium-independent vasodilation, increases in nitric oxide production, inhibition of vascular smooth muscle cell growth and proliferation after injury, inhibition of RAAS and the endothelin system and inhibition of the sympathetic nervous system 2, 3, 10, 30 . The loss of the vasoprotective effects mediated by estrogens would likely enhance BP rise.…”

Section: Discussionmentioning

confidence: 99%

The association between high-sensitivity C-reactive protein and hypertension in women of the CARDIA study

et al. 2016

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Objective The aim of this study was to determine the prevalence of hypertension in mid-life women, characterize the association between high sensitivity C-reactive protein (hs-CRP) and hypertension in women, and describe differences in hypertension prevalence by menopausal stage. Methods We included 1625 women, aged 43-55 years, with measurements of hs-CRP and detailed reproductive histories in the Coronary Artery Risk Development in Young Adults Study at follow up year 25. Prevalent hypertension was defined as a systolic blood pressure of 140 mm hg, or diastolic blood pressure of 90 mm hg, or greater or use of antihypertensive medications. Logistic regression was used for analysis. Results The prevalence of hypertension was 25.8 %, 37.8 %, and 39.0 % in premenopausal, perimenopausal and postmenopausal women respectively. The median (25th, 75th percentiles) of hs-CRP was 3.08 (1.12, 7.98) μg/ml and 1.18 (0.48, 3.15) μg/ml in women with and without hypertension respectively. After adjusting for confounders, metabolic factors and body mass index (BMI), a doubling (100% increment) in hs-CRP levels was significantly associated with hypertension in premenopausal (1.27 [1.01 - 1.59]) but not in perimenopausal (1.12 [0.99 - 1.27]) or postmenopausal (1.09 [0.95 - 1.26]) women. Conclusions Hypertension was common in mid-life women. The association of hs-CRP and hypertension was consistent across menopausal stages. The association of hs-CRP with hypertension was independent of BMI in premenopausal but not in perimenopausal or postmenopausal women.

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Section: Discussionmentioning

confidence: 99%

The association between high-sensitivity C-reactive protein and hypertension in women of the CARDIA study

et al. 2016

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“…Sex differences in the role of diabetes in the development of hypertension and cardiovascular disease have been studied extensively over the last few decades [ 39 ], [ 40 – 43 ]. While both men and women exhibit age-related increases in blood pressure, premenopausal women have a lower incidence of hypertension than age-matched men [ 44 , 45 ]. After the age of 55, hypertension incidence in women markedly increases with nearly 70% of women over 65 being diagnosed with hypertension in the USA [ 41 ].…”

Section: Introductionmentioning

confidence: 99%

Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging

et al. 2020

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Purpose of Review Precision Aging® is a novel concept that we have recently employed to describe how the model of precision medicine can be used to understand and define the multivariate risks that drive age-related cognitive impairment (ARCI). Hypertension and cardiovascular disease are key risk factors for both brain function and cognitive aging. In this review, we will discuss the common mechanisms underlying the risk factors for both hypertension and ARCI and how the convergence of these mechanisms may be amplified in an individual to drive changes in brain health and accelerate cognitive decline. Recent Findings Currently, our cognitive health span does not match our life span. Age-related cognitive impairment and preventing and treating ARCI will require an in-depth understanding of the interrelated risk factors, including individual genetic profiles, that affect brain health and brain aging. Hypertension and cardiovascular disease are important risk factors for ARCI. And, many of the risk factors for developing hypertension, such as diabetes, smoking, stress, viral infection, and age, are shared with the development of ARCI. We must first understand the mechanisms common to the converging risk factors in hypertension and ARCI and then design person-specific therapies to optimize individual brain health. Summary The understanding of the convergence of shared risk factors between hypertension and ARCI is required to develop individualized interventions to optimize brain health across the life span. We will conclude with a discussion of possible steps that may be taken to decrease ARCI and optimize an individual's cognitive life span.

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“…In both women and men, there is an age-related increase in blood pressure (BP). However, women under the age of 50 have a lower incidence of hypertension than age-matched men [2,3]. After age 55, the incidence of hypertension in women markedly increases and almost 70 % of women aged over 65 in the U.S.A. are hypertensive [4].…”

Section: Introductionmentioning

confidence: 99%

Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors

Hay

2015

Clinical Science

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Hypertension is a major contributor to worldwide morbidity and mortality rates related to cardiovascular disease. There are important sex differences in the onset and rate of hypertension in humans. Compared with age-matched men, premenopausal women are less likely to develop hypertension. However, after age 60, the incidence of hypertension increases in women and even surpasses that seen in older men. It is thought that changes in levels of circulating ovarian hormones as women age may be involved in the increase in hypertension in older women. One of the key mechanisms involved in the development of hypertension in both men and women is an increase in sympathetic nerve activity (SNA). Brain regions important for the regulation of SNA, such as the subfornical organ, the paraventricular nucleus and the rostral ventral lateral medulla, also express specific subtypes of oestrogen receptors. Each of these brain regions has also been implicated in mechanisms underlying risk factors for hypertension such as obesity, stress and inflammation. The present review brings together evidence that links actions of oestrogen at these receptors to modulate some of the common brain mechanisms involved in the ability of hypertensive risk factors to increase SNA and blood pressure. Understanding the mechanisms by which oestrogen acts at key sites in the brain for the regulation of SNA is important for the development of novel, sex-specific therapies for treating hypertension.

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A Single Pill to Treat Postmenopausal Hypertension? Not Yet

Cited by 10 publications

References 56 publications

The association between high-sensitivity C-reactive protein and hypertension in women of the CARDIA study

The association between high-sensitivity C-reactive protein and hypertension in women of the CARDIA study

Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging

Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors

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