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Altered vascular stiffness and central pulse wave parameters in climacteric women

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.153

Abstract

Aim: to assess changes in parameters of vascular stiffness, central aortic pressure (CAP) as well as reflected pulse wave in women in different phases of the climacteric period.

Materials and Methods. An open non-randomized single-center comparative study was conducted with 384 menopausal women subdivided into: Group 1 – 168 women at menopausal transition, Group 2 – 216 women at early postmenopause. A 24-hour blood pressure (BP) monitoring was performed with assessing daily dynamics of parameters of arterial stiffness, CAP and reflected pulse wave. The aortic pulse wave velocity and local aortic stiffness were estimated.

Results. It was found that women in early postmenopausal period vs. menopausal transition showed significantly higher values of daily central BP combined with more prominent changes in vascular stiffness. Menopausal women were characterized by lowered difference between nocturnal central and peripheral BP level (less amplified nocturnal vs. diurnal peripheral BP magnitude), which is associated with a greater augmented CAP at this time point. Such pattern was more pronounced in women at postmenopausal period.

Conclusion. Women in climacteric period were found to have increased vascular stiffness combined with elevated CAP, decreased amplification of pulse pressure and increased amplitude of the reflected pulse wave may be associated with increased risk of cardiovascular complications. Much more prominent changes were noted in women in early postmenopausal period.

About the Authors

I. A. Salov
Saratov State Medical University named after V.I. Razumovsky, Health Ministry of Russian Federation
Russian Federation

Igor A. Salov – MD, Dr Sci Med, Professor, Head of the Department of Оbstetrics and Gynecology, Faculty of General Medicine

112 Bolshaya Kazachya Str., Saratov 410012, Russia



S. N. Tolstov
Saratov State Medical University named after V.I. Razumovsky, Health Ministry of Russian Federation
Russian Federation

Sergey N. Tolstov – MD, Dr Sci Med, Professor, Department of Therapy with Courses in Cardiology, Functional Diagnostics and Geriatrics

112 Bolshaya Kazachya Str., Saratov 410012, Russia



A. P. Rebrov
Saratov State Medical University named after V.I. Razumovsky, Health Ministry of Russian Federation
Russian Federation

Andrey P. Rebrov – MD, Dr Sci Med, Professor, Head of the Department of Hospital Therapy, Faculty of General Medicine

112 Bolshaya Kazachya Str., Saratov 410012, Russia



References

1. Newson L. Menopause and cardiovascular disease. Post Reprod Health. 2018;24(1):44–9. https://doi.org/10.1177/2053369117749675.

2. Stefanska A., Bergmann K., Sypniewska G. Metabolic syndrome and menopause: pathophysiology, clinical and diagnostic significance. Adv Clin Chem. 2015;72:1–75. https://doi.org/10.1016/bs.acc.2015.07.001.

3. Yureneva S.V., Ilyina L.M. Female reproductive system aging: From theory to clinical practice. Part 2. Role of hormone therapy in solving the problems of transition stage and early postmenopause. [Starenie reproduktivnoj sistemy zhenshchin: ot teorii k klinicheskoj praktike. Chast' II. Rol' gormonal'noj terapii v reshenii problem perekhodnogo perioda i rannej postmenopauzy]. Akusherstvo i ginekologiya. 2014;(4):17–24. (In Russ.).

4. Baber R.J., Panay N. Fenton A. and the IMS Writing Group NS 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016;19(2):109–50. https://doi.org/10.3109/13697137.2015.1129166.

5. Laurent S., Cockcroft J., Van Bortel L. et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605. https://doi.org/10.1093/eurheartj/ehl254.

6. Vlachopoulos C., Xaplanteris P., Aboyans V. et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis. 2015;241:507–32. https://doi.org/10.1016/j.atherosclerosis.2015.05.007.

7. Regnault V., Thomas F., Safar M.E. et al. Sex difference in cardiovascular risk: role of pulse pressure amplification. J Am Coll Cardiol. 2012;15;59(20):1771–7. https://doi.org/10.1016/j.jacc.2012.01.044.

8. Bordin Pelazza B., Filho S.R.F. Comparison between central and brachial blood pressure in hypertensive elderly women and men. Int J Hypertens. 2017;2017:6265823. https://doi.org/10.1155/2017/6265823.

9. Tolstov S.N., Salov I.A., Rebrov A.P. Structural and functional changes of blood vessels in women in early postmenopause, the possibility of correction of the revealed violations. [Strukturno-funkcional'nye izmeneniya sosudov u zhenshchin v rannej postmenopauze, vozmozhnosti korrekcii vyyavlennyh narushenij]. Kardiologiya. 2018;58(S1):56–64. https://doi.org/10.18087/cardio.2425.

10. Kaess B.M., Rong J., Larson M.G. et al. Relations of central hemodynamics and aortic stiffness with left lentricular structure and function: The Framingham Heart Study. J Am Heart Assoc. 2016;5(3):e002693. https://doi.org/10.1161/JAHA.115.002693.

11. Williams B., Lacy P.S., Baschiera F. et al. Clinical trial: the ambulatory central aortic pressure (AmCAP) study blood pressure and the impact of blood pressure treatment in a randomized controlled novel description of the 24-hour circadian rhythms of brachial versus central aortic. Hypertension. 2013;61(6):1168–76. https://doi.org/10.1161/HYPERTENSIONAHA.111.00763.

12. Sarafidis P.A., Loutradis C., Karpetas A. et al. Ambulatory pulse wave velocity is a stronger pedictor of cardiovascular events and all-cause mortality than office and ambulatory blood pressure in hemodialysis patients. Hypertension. 2017;70(1):148–57. https://doi.org/10.1161/HYPERTENSIONAHA.117.09023.


Review

For citations:


Salov I.A., Tolstov S.N., Rebrov A.P. Altered vascular stiffness and central pulse wave parameters in climacteric women. Obstetrics, Gynecology and Reproduction. 2020;14(4):479-489. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.153

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)