Sex hormone levels and carotid intimal-medial thickness in postmenopausal women with and without hypertension

Abstract

Hypertension, which is common in postmenopausal women, increases the risk of cardiovascular disease by altering the integrity of the endothelium. Subclinical atherosclerosis can be early diagnosed by measuring the carotid intimal-medial thickness [CIMT]. In postmenopausal women, the ovary secretes testosterone [T] and androstenedione [A4], which are converted to estradiol [E2] and estrone [E1] respectively. Increased serum levels of T and decreased levels of sex hormone-binding globulin [SHBG] are postulated to be related to hypertension in postmenopausal women. Objectives: To explore possible differences in serum levels of E1, E2, T, A4, SHBG and free T in postmenopausal women with and without hypertension and identify whether there is a relationship between hormone levels and the CIMT. Subjects: 42 postmenopausal ambulatory women, attended at the Institute A. Lanari (Buenos Aires, Argentina), aged 50 to 80 years, with body mass index [BMI] <30. Blood pressure was measured with an automatic blood pressure monitor, hormone levels by chemiluminescence or radioimmunoassay and the CIMT by Doppler-ultrasound. The Mann-Whitney test and Spearman correlation were used.
Results: Out of the 42 women analyzed, 20 were hypertensive [48%], 18 were overweight and the CIMT was 0.7±0.1 mm. The group of hypertensive women were older [68±6 vs. 63±6], and had higher BMI [25±3 vs. 23±3], higher levels of E1 [4.85 vs. undetectable pg/ml], higher levels of free T [1.6 vs. 0.9 pg/ml] and higher values of CIMT [0.8±0.1 vs. 0.6±0.1 mm] than normotensive ones. The higher values of CIMT were related to older age [r=0.46, p<0.05] and to lower