Ovarian hormone exposure and risk of hypertension

Abstract

INTRODUCTION: Blood pressure is commonly lower in reproductive aged women compared with age-matched men. Ovarian hormone could have significant health implications in later life. Thus, we examined whether ovarian hormone exposure is independently associated with the risk of hypertension among general Korean women. In addition, we evaluated the reliability of recall for age at menarche in adult.

METHODS: To evaluate the association between ovarian hormone exposure and hypertension risk, we analyzed baseline and follow-up data from 4,538 women from Korean Genome and Epidemiology Study-Kangwha (n=2,948) and ardiovascular and Metabolic Disease Etiology Research Center study (n=1,590). Reproductive factors were measured by interviewer-assisted questionnaire. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, diagnosed of hypertension from physician, or current antihypertensive drug usage. We used multivariable logistic regression models to estimate the odds ratio (OR) for prevalent hypertension at baseline according to menarche (≤12, 13-14, 15-16, and ≥17 years), menopause (≤45, 46-48, 49-51, and ≥52 years), and reproductive duration (≤29, 30-33, 34-37, and ≥38 years). Time-to-event analysis using Kaplan-Meier curves was performed for probability of participants with hypertension risk. Age, cohort, total cholesterol, health behaviors, socioeconomic status, reproductive factors, and adult body mass index were considered as a covariates.

RESULTS: Prevalence of hypertension increased significantly in the earliest menarche group (OR 1.466, 95% CI: 1.023-2.100), the earliest menopause group (OR 1.323, 95% CI: 1.028-1.705), and the shortest reproductive duration group (OR 1.456, 95% CI: 1.161-1.825). Women with both early ages at menarche and menopause, the risk for hypertension was increased nearly four-fold (OR 3.732, 95% CI=1.588-8.769). Compared to other groups, the earliest menarche group (≤12 years) appeared to be ahead of the onset risk of hypertension and there was a significant differences from the menarche age (p=0.002) and chronological year (p=0.001).

CONCLUSION: Early menarche, early menopause with short ovarian hormone exposure increased the risk of hypertension among Korean women. Early menarche may contribute to early onset of hypertension by increasing blood pressure since uberty has begun.