Blood pressure and menopausal transition: The Atherosclerosis Risk In Communities Study (1987-95)

Objective. Blood pressure changes during menopausal transition have not been studied previously using a biracial sample. We invesigated whether menopausal transition was associated with change in blood pressure in African-American or white women. Design, setting and participants. The prospective multicenter study, the Atherosclerosis Risk In Communities (ARIC) Study (1987-95) was utilized. Included were never-users of hormone replacement therapy (3800 women, 44% of the original sample). Main outcome measure. Changes in blood pressure were adjusted for baseline age and body mass index, baseline blood pressure, antihypertensive use, ARIC field center and weight change. The menopausal transition group was compared to the non-transition group, separately, by ethnicity. Results. Women undergoing the menopausal transition did not differ significantly in regard to systolic blood pressure change [5.2, 95% confidence interval (CI) 4.0-6.4] from non-transitional women (4.6, 95% CI 4.0-5.2); adjustment for age, baseline systolic blood pressure and other factors did not alter this finding. Transitional women had significantly less diastolic blood pressure change (-0.5, 95% CI -1.1 to 0.2) than non-transitional women (-2.0, 95% CI -2.4 to -1.7, P = 0.000) but, after adjustment for other covariates, the result was not significant. African-American women had significantly (P = 0.003) higher systolic blood pressure change compared to white women, but this difference became non-significant (P = 0.21) after restricting the sample to women younger than 55 years of age. Interactions between menopausal transition and ethnicity were not significant, either in systolic blood pressure or diastolic blood pressure change. Conclusion. Menopausal transition is not associated with significant blood pressure change in African-American or white women. (C) Lippincott Williams and Wilkins.