Circadian Pattern of Blood Pressure and Cardiovascular Autonomic Regulation During Different Phases of Pre- and Post-menopausal Women: A 24 hours & 7 days Study
Article Sidebar
Main Article Content
Abstract
Background: A significant difference in cardiovascular health exists between males and females, but marked differences can be observed in women of similar age groups also. Many studies were performed that suggested the role of several female sex hormones as a causal factor for increased cardiovascular risk but very less studies were present that directly focused on the role of circadian rhythmicity of blood pressure and cardiovascular autonomic regulation in postmenopausal women as well premenopausal women during different phases of menstrual cycle.
Objective: The present study is aimed to assess the twenty hours seven days circadian reproducibility of blood pressure and autonomic regulation of cardiovascular system providing alteration in the various menstrual phases in pre-menopausal and post-menopausal age groups.
Materials and methods: This was a comparative study of 50 pre- and 50 post-menopausal age group women done with the help of a structured questionnaire, ambulatory blood pressure monitoring (24-hour, 4-7 days), and autonomic nervous system monitoring and heart rate variability.
Results: The study shows significant changes in autonomic regulation of postmenopausal women compared to the premenopausal group, with significant differences between MESOR of Systolic BP, diastolic BP and HR. Increased circadian amplitude in postmenopausal women, suggestive of overall decreased chronobiological parameters of cardiovascular system in post-menopausal group.
Conclusion: Correlation of circadian patterns of Blood pressure and their correlation with autonomic regulation and heart rate variability could have clinical significance in the treatment and Pre-habilitation of cardiovascular diseases at earlier or primordial stages in postmenopausal as well as premenopausal women.
Metrics
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
All open access articles published in the journal are distributed under the terms of the CC-BY-NC-SA 4.0 license (Creative Commons Attribution-Non-commercial-ShareAlike 4.0 International License) which permits unrestricted use, distribution, and reproduction in any medium, for non-commercial purposes, provided the original work is properly cited and distributed under the same license (ShareAlike). Under Creative Commons, authors retain copyright in their articles.
References
Weiner CP, Lizasain I, Baylis SA, Knowles RG, Charles IG, Moncada S. Induction of calcium dependent NO synthase by sex hormones. Proc Natl Acad Sci U S A.;91:5212–5216.
Pei-Shan Tsai, Carolyn B. Yucha, David Sheffield and Mark Yang, (2003) Effects of Daily Activities on Ambulatory Blood Pressure During Menstrual Cycle in Normotensive Women; Applied Psychophysiology and Biofeedback, 28(1):25-36.
Dunne FP, Barry DG, Ferriss JB, Grealy G, Murphy D . (1991) Changes in blood pressure during the normal menstrual cycle. Clin Sci (Lond). Oct;81(4):515-8.
Manhem K, Jern S, (1994 )Influence of daily-life activation on pulse rate and blood pressure changes during the menstrual cycle. J Hum Hypertens. Nov;8(11):851-6.
Victoria Hall Moran, Helen L. Leathard and John Coley. (2000), Cardiovascular functioning during the menstrual cycle,Clinical Physiology 20, 6, 496-504.
Karpanou EA, Vyssoulis GP, Georgoudi DG, Toutouza MG, Toutouzas PK. (1993). Ambulatory blood pressure changes in the menstrual cycle of hypertensive women. Significance of plasma renin activity values, Am J Hypertens. ;6(8):654-9.
S. L. Colverson , J. E. James . (1996) Change in haemodynamic profile during phases of the menstrual cycle . Gregg Psychology, Health & Medicine, 1(3):307-314.
Adkisson EJ, Casey DP, Beck DT, Gurovich AN, Martin JS, Braith RW (2010). Central, peripheral and resistance arterial reactivity: fluctuates during the phases of the menstrual cycle. Exp Biol Med (Maywood). 235(1):111-8.
Hirshoren N, Tzoran I, Makrienko I, Edoute Y, Plawner MM, Itskovitz- Eldor J, Jacob G. (2002). Menstrual cycle effects on the neurohumoral and autonomic nervous systems regulating the cardiovascular system. J Clin Endocrinol Metab 87: 1569–1575.
Jones PP, Shapiro LF, Keisling GA, Jordan J, Shannon JR, Quaife RA, Seals DR. (2001). Altered autonomic support of arterial blood pressure with age in healthy men. Circulation 104: 2424–2429.
Calhoun DA, Zhu S, Wyss JM, Oparil S. (1994) Diurnal blood pressure variation and dietary salt in spontaneously hypertensive rats. Hypertension.; 24: 1–7.
August P, Oparil S. (1999). Commentary: hypertension in women. J Clin Endocrinol Metab.;84:1862–1866.
JAMA; (1995) The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/ progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA.;273:199 –208.
Pripp U, Hall G, Csemiczky G, Eksborg S, Landgren BM, Schenck- Gustafsson K. (1999) .A randomized trial on effects of hormone therapy on ambulatory blood pressure and lipoprotein levels in women with coronary artery disease. J Hypertens; 17:1379 – 1386.
Van Ittersum FJ, Van Baal WM, Kenemans P, Mijatovic V, Donker AJ, van der Mooren MJ, Stehouwer CD. (1998). Ambulatory—not office— blood pressures decline during hormone replacement therapy in healthy postmenopausal women. Am J Hypertens; 11:1147–1152.
Seely EW, Walsh BW, Gerhard MD, Williams GH. (1999). Estradiol with or without progesterone and ambulatory blood pressure in postmenopausal women. Hypertension.; 33:1190 –1194.
Beljic T, Babic D, Marinknvic J, Prelevic GM. The effect of hormone replacement therapy on diastolic left ventricular function in hypertensive and normotensive postmenopausal women. Maturitas. . 1998;29:229 –238.
Jiroutek MR, Chen MH, Johnston CC, Longcope C. (1998). Changes in reproductive hormones and sex hormone-binding globulin in a group of postmenopausal women measured over 10 years. Menopause.5:90-94.
Laughlin GA, Barrett-Connor E, Kritz-Silverstein D, von Muhlen D. (2000). Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study. J Endocrinol Metab.; 85:645– 651.
Reckelhoff JF, Zhang H, Srivastava K. (2000). Gender differences in the development of hypertension in SHR: role of the renin-angiotensin system. Hypertension. 35:480–483.
Julio C. Sartori-Valinotti, Radu Iliescu, Licy L. Yanes, Wanda Dorsett-Martin, Jane F. Reckelhoff (2008). Sex Differences in the Pressor Response to Angiotensin II when the Endogenous Renin-Angiotensin System Is Blocked. Hypertension;51;1170- 1176.
María Jesús García, José Manuel Martínez-Martos, María Dolores Mayas, María Pilar Carrera and María Jesús Ramírez-Expósito, (2003) Hormonal status modifies renin-angiotensin system-regulating aminopeptidases and vasopressin-degrading activity in the hypothalamus-pituitary-adrenal axis of male mice. Life Sciences Volume 73, Issue 5, 20 June, Pages 525-538.
Norma B. Ojeda, Daniela Grigore, Licy L. Yanes, Radu Iliescu, Elliot B. Robertson, Huimin Zhang, and Barbara T. Alexander (2007). Testosterone contributes to marked elevations in mean arterial pressure in adult male intrauterine growth restricted offspring; Am J Physiol Regul Integr Comp Physiol 292: R758-R763.
Saab PG, Matthews KA, Stoney CM, McDonald RH. (1989). Premenopausal and postmenopausal women differ in their cardiovascular and neuroendocrine responses to behavioral stressors. Psychophysiology 26:270–280.
Owens J, Stoney C, Matthews KA. (1993). Menopausal status influences ambulatory blood pressure levels and blood pressure changes during mental stress. Circulation 88:2794– 2802.
Farag NH, Bardwell WA, Nelesen RA, Dimsdale JE, Mills PJ. (2003). Autonomic responses to psychological stress: The influence of menopausal status. Ann Behav Med 26:134– 138.
Reiter RJ (1980) The pineal and its hormones in the control of reproduction in mammals. Endocr Rev 1:109–131.
Malpaux B, Migaud M, Tricoire H, and Chemineau P (2001) Biology of mammalian photoperiodism and the critical role of the pineal gland and melatonin. J Biol Rhythms 16:336–347.
Brzezinski A, Lynch HJ, Seibel MM, (1988). The circadian rhythm of plasma melatonin during normal menstrual cycle and in amenorrheic women. J Clin Endocrinol Metab.;66:891-895.
Masana MI, Doolen S, Ersahin C, Al-Ghoul WM, Duckles SP, Dubocovich ML, and Krause DN (2002) MT2 melatonin receptors are present and functional in rat caudal artery. J Pharmacol Exp Ther 302:1295–1302.
Okatani Y, Morioka N, Wakatsuki A. (2000) Changes in nocturnal melatonin secretion in perimenopausal women: correlation with endogenous estrogen concentrations. J Pineal Res;28:111-118.
Aleandri V, Spina V, Morini A. (1996). The pineal gland and reproduction. Hum Reprod Update;2:225-235.
Shibui K, Uchiyama M, Okawa M, et al 2000. Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle. Biol Psychiatry. 2000;48:1062- 1068.
G. Bellipannia, P. Bianchia,1, W. Pierpaolib, D. Bulianb, E. Ilyia., (2001) Effects of melatonin in perimenopausal and menopausal women: a randomized and placebo controlled study. Experimental Gerontology 36, 297-310.
Angelo Cagnacci, Anna Maria Paoletti, Renza Soldani, Marisa Orrtj, Elisabetta Maschio, and Gian Benedetto Melis, (1995). Melatonin Enhances the Luteinizing Hormone and Follicle-Stimulating Hormone Responses to Gonadotropin-Releasing Hormone in the Follicular, but Not in the Luteal, Menstrual Phase, Journal of clinical endocrinology and metabolism, 80(4):1095-1099.
Daniel F Kripke, Lawrence E Kline, Farhad F Shadan, Arthur Dawson, J Steven Poceta and Jeffrey A Elliott. (2006). Melatonin effects on luteinizing hormone in postmenopausal women: a pilot clinical trial NCT00288262. BMC Women's Health, 6:8.
Frank AJ, L. Scheer, Gert A. Van Montfrans, Eus J.W. van Someren, Gideon Mairuhu, Ruud M. Buijs, (2004).Daily Nighttime Melatonin Reduces Blood Pressure in Male Patients With Essential Hypertension; Hypertension;43;192-197
Lusardi P, Piazza E, Fogari R. (2000). Cardiovascular effects of melatonin in hypertensive patients well controlled by nifedipine: A 24-hour study. Br J Clin Pharmacol.;49(5):423-7.
Guzzetti, S., Dassi, S., Pecis, M., et al. (1991). Altered pattern of circadian neural control of heart period in mild hypertension. J Hypertens. 9: 831–838.
Ehud Grossman, MD, Moshe Laudon, PhD, Ridvan Yalcin, MD, Hakan Zengil, PhD, Edna Peleg, PhD, Yehonatan Sharabi, MD, Yehuda Kamari, MD, Zila Shen- Orr, M.Sc, Nava Zisapel, Melatonin Reduces Night Blood Pressure in Patients with Nocturnal Hypertension . The American Journal of Medicine (2006) 119, 898-902.
Hermida RC, Calvo C, Ayala DE, Soler R, Mojo´n A, Lo´pez JE, Rodrı´guez M, Chaya´n L, Fontao MJ, Alonso I, Ferna´ndez JR. (2007). Ambulatory Blood Pressure Monitoring in the Prediction of Cardiovascular Events and Effects of Chronotherapy: Rationale and Design of the MAPEC Study, Chronobiology International, 24(4),749-77.
Bonnemeier H, Hartmann F, Wiegand UK, et al.(2000): Heart rate variability in patients with acute myocardial infarction undergoing primary coronary angioplasty. Am J Cardiol; 85 815-820.
Miller-Craig MW, Bishop CN, Raftery EB. (1978 ) .Circadian variation of blood pressure. Lancet;1:795–797.
Pavlov VA, Tracey KJ.(2005): The cholinergic anti-inflammatory pathway. Brain Behav Immun; 19:493–499
Lanza GA, Sgueglia GA, Cianl one D, (2006): Relation of heart rate variability to serum levels of C-reactive protein in patients with unstable angina pectoris. Am J Cardiol; 97:1702–1706
T Rosenthal and S Oparil, (2000) Hypertension in women; Journal of Human Hypertension .14, 691–704.
Overlie I, Moen MH, Morkrid L, Skjaeraasen JS, Holte A. The endocrine transition around menopause: a five year prospective study with profiles of gonadotropins, estrogens, androgens and SHBG among healthy women. Acta Obstet Gynecol Scand. 1999;78:642– 647.
Portaluppi F, Smolensky MH. (2000). Circadian rhythm and environmental determinants of blood pressure regulation in normal and hypertensive conditions. InWhiteWB (ed.). Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics. Totowa, New Jersey: Humana Press, pp. 79–118.
Hermida RC, Ayala DE, Ferna´ndez JR, Mojo´n A, Alonso I, Calvo C. (2002a). Modeling the circadian variability of ambulatorily monitored blood pressure by multiple-component analysis. Chronobiol. Int. 19:461–481.
Hermida RC, Calvo C, Ayala DE, Mojo´n A, Lo´pez JE. (2002b). Relationship between physical activity and blood pressure in dipper and nondipper hypertensive patients. J. Hypertens. 20:1097–1104.
Sica DA, Wilson DK. (2000). Sodium, potassium, the sympathetic nervous system, and the renin-angiotensin system: Impact on the circadian variability in blood pressure. In White WB (ed.). Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics. Totowa, New Jersey: Humana Press, pp. 171–190.