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Effect of menopause on day-night blood pressure changes and left ventricular function in hypertension
12A
ASH XII ABSTRACTS
AJH-APRfL 1997-VOL. 10, NO. 4, PART 2
CHRONIC EXOGENOUS HYPERINSULINEML4 (CHf) IN PREGNANCY: A RAT MODEL OF PREGNANCY INDUCED HYPERTENS1ON (PIH).
ESTROGENREPLAcmtENf THE.RAPY IMPROVE6WNAL VASCULARRESPONSE TO LARGMNE n4MENOPAUSAL
M BuraztwLE Podjarny*,J Bembeim. HadaaaabUniversity
Ribatein J, Du Cailar G, Mimran A, Department of Medicine.CHU, Montpcllier.Fmrree Genderdifferenceshavebeendemibed in the occurrence
Hospitaf,Mt-Swpua, Jcruaafcrn, aadMcirHoapitsl, Kfar-Sab~Td-Aviv University,keel. aremaociatatwith fnsuiiarcaiataaceaedhyperimsalinernia PEf ToevaluateRreeffectof CHI on blood pressureirrnonrxjl p-q (p). a Sumkd-rckaacinadhtpelletw= impfantad SC.irr 15 I* (P-INS) a weak before, and orrday 7 of P; 14 eonuelratawere&m implanted (P-SHAM).Taikuffayasolic blwd pressure (SBP) before madng was 97+7 arrd 99+5 mrrdig irr P-SHAM aad P-INS rata rcapedively.Rcarrfta (ANCOVA)by thecrrdof P (mcens+ad) aresfrowmbelow: ● p
bodyWC@t(~.) numberoffetuaas imufin (pmnf) wrerrr glucoae(rrs#f) senrrrrbiglyceri&(mgMl) aemrrrNa+(mcqfl) fraedorsal Na+exeredon(Y.)
110+18 ‘t 335*3 I
85+12 t 3ff%t19
8.7*2.3*
11.1+2.4
27&l 1 “
14+4 115+10
82+16* 366+208+ 158i70 137+4* 127+6
4,441.s 3,1+1.0 ● 233A14 * 370+17 A NOJFJ03 (%) Water aed food intake,urinevolume, cmdirrinecl-cc,
WOMENWTTH5SENHALHYPERTENSION
of several vaamdar disordera aa well aa the evolution of mud diseaat. We previously showed that the renal vaaodilatory rcsporrss to L-Arginirtc (LA) was blunted in
easetttiolhypertension(Elf) in associationwith a lack of increasein urinarycGMP despitea rise in NQ-/NQ-. In the presentstudiee,we tested whetherthe administsatiorrof eatrogett replacementtherapy (ERT) may infhrence the effectof LA irrfuaion(30g within60 rein) on mean artcriaf P smdrcmd function(effectivererralplasma ~~;~wdWaLglomedafiltitio” rate, GFR e#.imated by continuousinfusionof 1311 -hippurmrand 99WC-DTPA respectively arrd mine ccdlectiorra)in 20 never-treated, rrorrrroalburrrinuric EH. Age, body weight, lipid levels, duration of hypettettsionand ERT, as well as baseline bbmd pressureand renal functionwere similar in pafienta with or without ERT. Results (meawfmf) are expressed aa % changefrom basal vafrres.
arrdlevel of proteirurriaat errdof P were simifar.Thougb glueoae waa lower in P-fNS, there was .0 case of induced bWogfywmia. CH1,witboutsugar supplenreatetioa,
h4AP ERPf= GFR UNaV EH -4.7il.O +0.7&.6 -7.2*2.9 +43*11 EH+ERT -3.6* 1.2 +1 1.9*2.6 +3. 1*2.5 +ll&t18 NS 4.05 <0.05 <0.05 P vafue
PIH, with a kmaasd tktiorrsf Na+ exercdon suggesting a renal pathogenicmacbaniam.The MMRerrise in urinaryNO, tbrougbP mayrcprow.ntcndotietial dystirncdonin P-fNS asirr previousaturficaHypcrtrigfyccriderrria, a claasicsign of irrsufirr resiatarrce,as well as of PIH and the fewer fetuses testifies to “targetorgan”damageas seen in ofherPfHmodels,
These results indicate that estrogen replacementtherapy may improve the bhmtsd dilatory renal response to LArginineobaervedin essentialhypertension.Estrogensmay mffuettcethe mmalvaaomotortone via endotbelielfunction arrdthe nitricoxidepathway. Key Worda: EXsf3iwffALHYPERTENSION ;bARGININE ; NfmtcOXIDE;ES’tROGEN REPLACEMEiWf THERAFY
EFFECTOFMENOPAUSEONDAY-NIGHTBLODDPRESSURECHANGES ANDLEFTVENTRWJLARFUNCTIONIN HYPERTENSk3N, ~, P Verttecchla, C Borgloni,A Clueci,N Saechi,G Benemlo,C Pomellati,Dapt.of Cerdiolegy.SMadicfrre, SilvealrfniHospital,Perugia, andCitthdellaPieveHoapital,Italy, Age is an indapmdsnt prediefor of a blunted day-night bleed pressure(BP) reduction,a risk marker in eaeentialhypertension. However,if is not knownwhafharfmrrmsal imbalancesaseoeiated wfihmenepauaemayakerthe day-nightBP profile indapandentfyof age.To teatthis hypothesis,76 consecutiveuntreatedhyp@enaive womenaged 45-55 y with a normalovulatoryeyeia were aslactad from the PIUMA databaae and matched wkh 76 hypertensive women in post-menopausefrom 21 year (median,3 y). Subjects were individuallymatched (1:1 ratio) by age (+5 y) and cfinie SBP/DBP(both *5 mmHg) in a case-eontreldesign. All aubjaets underwent24-h ambulatoryBP mentioningin a normal work day, and M-mode and Doppler echecardiography.SubOptimalEcho, shift wotk, diabetesand use of estrogenswere exclusioncriieria. Awake and aalaer) pefbds raauffsd from patients’ diariea. BY matching,clinic BP a“ti control Mer?epaw age wereidentiealin the 2 groups. Aleo daytime BP, smoking status, slaspdurationand body maaa index did not differ. Menopausewas asawiatsd wkh a bluntsd nocturnal BP fall, a higher sleep BP, an aitered left ventricular (LV) diaalolic filling pattern and a nonsignificant increase in
(mm)
(n=76)
$0(3) Smoksrs,% Bcdymassindax,kgm”’ 26;2(4) 26fl(4) SIaspdurabn,h 6(2) 6(1) ClinicSBP/DBP,mmHg 15WB 1W99 AwakeSBP/DBP 142/91 141/91 SlwDSBP/DBP 119/72 123’/75’ lwt 12t/t7t SIsspSBP/DBPfall,% 1.07(,4) .95(.3)* E/Avelecityrstio 48(14) LVmass(g.m””) 49(11) ● P
!M(3)
LV mass (P-,13), as comparad wfih ovulatory women. In hypartenaive women,msnopauseis aaaociatedwth a blunteddaynightBP fall, indsparrdentlyof age arvdother potentialconfounder (average BP levels, aleep duration, smoking, obeeify, daytime activ’ ) andto an impairrd leftventriculardiastolicrelaxation. Ksy%’ orals: hypertension.ambulatoryBP monitoring. circadianvariation. menopau~
ASH XII ABSTRACTS
AJH-APRfL 1997-VOL. 10, NO. 4, PART 2
CHRONIC EXOGENOUS HYPERINSULINEML4 (CHf) IN PREGNANCY: A RAT MODEL OF PREGNANCY INDUCED HYPERTENS1ON (PIH).
ESTROGENREPLAcmtENf THE.RAPY IMPROVE6WNAL VASCULARRESPONSE TO LARGMNE n4MENOPAUSAL
M BuraztwLE Podjarny*,J Bembeim. HadaaaabUniversity
Ribatein J, Du Cailar G, Mimran A, Department of Medicine.CHU, Montpcllier.Fmrree Genderdifferenceshavebeendemibed in the occurrence
Hospitaf,Mt-Swpua, Jcruaafcrn, aadMcirHoapitsl, Kfar-Sab~Td-Aviv University,keel. aremaociatatwith fnsuiiarcaiataaceaedhyperimsalinernia PEf ToevaluateRreeffectof CHI on blood pressureirrnonrxjl p-q (p). a Sumkd-rckaacinadhtpelletw= impfantad SC.irr 15 I* (P-INS) a weak before, and orrday 7 of P; 14 eonuelratawere&m implanted (P-SHAM).Taikuffayasolic blwd pressure (SBP) before madng was 97+7 arrd 99+5 mrrdig irr P-SHAM aad P-INS rata rcapedively.Rcarrfta (ANCOVA)by thecrrdof P (mcens+ad) aresfrowmbelow: ● p
bodyWC@t(~.) numberoffetuaas imufin (pmnf) wrerrr glucoae(rrs#f) senrrrrbiglyceri&(mgMl) aemrrrNa+(mcqfl) fraedorsal Na+exeredon(Y.)
110+18 ‘t 335*3 I
85+12 t 3ff%t19
8.7*2.3*
11.1+2.4
27&l 1 “
14+4 115+10
82+16* 366+208+ 158i70 137+4* 127+6
4,441.s 3,1+1.0 ● 233A14 * 370+17 A NOJFJ03 (%) Water aed food intake,urinevolume, cmdirrinecl-cc,
WOMENWTTH5SENHALHYPERTENSION
of several vaamdar disordera aa well aa the evolution of mud diseaat. We previously showed that the renal vaaodilatory rcsporrss to L-Arginirtc (LA) was blunted in
easetttiolhypertension(Elf) in associationwith a lack of increasein urinarycGMP despitea rise in NQ-/NQ-. In the presentstudiee,we tested whetherthe administsatiorrof eatrogett replacementtherapy (ERT) may infhrence the effectof LA irrfuaion(30g within60 rein) on mean artcriaf P smdrcmd function(effectivererralplasma ~~;~wdWaLglomedafiltitio” rate, GFR e#.imated by continuousinfusionof 1311 -hippurmrand 99WC-DTPA respectively arrd mine ccdlectiorra)in 20 never-treated, rrorrrroalburrrinuric EH. Age, body weight, lipid levels, duration of hypettettsionand ERT, as well as baseline bbmd pressureand renal functionwere similar in pafienta with or without ERT. Results (meawfmf) are expressed aa % changefrom basal vafrres.
arrdlevel of proteirurriaat errdof P were simifar.Thougb glueoae waa lower in P-fNS, there was .0 case of induced bWogfywmia. CH1,witboutsugar supplenreatetioa,
h4AP ERPf= GFR UNaV EH -4.7il.O +0.7&.6 -7.2*2.9 +43*11 EH+ERT -3.6* 1.2 +1 1.9*2.6 +3. 1*2.5 +ll&t18 NS 4.05 <0.05 <0.05 P vafue
PIH, with a kmaasd tktiorrsf Na+ exercdon suggesting a renal pathogenicmacbaniam.The MMRerrise in urinaryNO, tbrougbP mayrcprow.ntcndotietial dystirncdonin P-fNS asirr previousaturficaHypcrtrigfyccriderrria, a claasicsign of irrsufirr resiatarrce,as well as of PIH and the fewer fetuses testifies to “targetorgan”damageas seen in ofherPfHmodels,
These results indicate that estrogen replacementtherapy may improve the bhmtsd dilatory renal response to LArginineobaervedin essentialhypertension.Estrogensmay mffuettcethe mmalvaaomotortone via endotbelielfunction arrdthe nitricoxidepathway. Key Worda: EXsf3iwffALHYPERTENSION ;bARGININE ; NfmtcOXIDE;ES’tROGEN REPLACEMEiWf THERAFY
EFFECTOFMENOPAUSEONDAY-NIGHTBLODDPRESSURECHANGES ANDLEFTVENTRWJLARFUNCTIONIN HYPERTENSk3N, ~, P Verttecchla, C Borgloni,A Clueci,N Saechi,G Benemlo,C Pomellati,Dapt.of Cerdiolegy.SMadicfrre, SilvealrfniHospital,Perugia, andCitthdellaPieveHoapital,Italy, Age is an indapmdsnt prediefor of a blunted day-night bleed pressure(BP) reduction,a risk marker in eaeentialhypertension. However,if is not knownwhafharfmrrmsal imbalancesaseoeiated wfihmenepauaemayakerthe day-nightBP profile indapandentfyof age.To teatthis hypothesis,76 consecutiveuntreatedhyp@enaive womenaged 45-55 y with a normalovulatoryeyeia were aslactad from the PIUMA databaae and matched wkh 76 hypertensive women in post-menopausefrom 21 year (median,3 y). Subjects were individuallymatched (1:1 ratio) by age (+5 y) and cfinie SBP/DBP(both *5 mmHg) in a case-eontreldesign. All aubjaets underwent24-h ambulatoryBP mentioningin a normal work day, and M-mode and Doppler echecardiography.SubOptimalEcho, shift wotk, diabetesand use of estrogenswere exclusioncriieria. Awake and aalaer) pefbds raauffsd from patients’ diariea. BY matching,clinic BP a“ti control Mer?epaw age wereidentiealin the 2 groups. Aleo daytime BP, smoking status, slaspdurationand body maaa index did not differ. Menopausewas asawiatsd wkh a bluntsd nocturnal BP fall, a higher sleep BP, an aitered left ventricular (LV) diaalolic filling pattern and a nonsignificant increase in
(mm)
(n=76)
$0(3) Smoksrs,% Bcdymassindax,kgm”’ 26;2(4) 26fl(4) SIaspdurabn,h 6(2) 6(1) ClinicSBP/DBP,mmHg 15WB 1W99 AwakeSBP/DBP 142/91 141/91 SlwDSBP/DBP 119/72 123’/75’ lwt 12t/t7t SIsspSBP/DBPfall,% 1.07(,4) .95(.3)* E/Avelecityrstio 48(14) LVmass(g.m””) 49(11) ● P
!M(3)
LV mass (P-,13), as comparad wfih ovulatory women. In hypartenaive women,msnopauseis aaaociatedwth a blunteddaynightBP fall, indsparrdentlyof age arvdother potentialconfounder (average BP levels, aleep duration, smoking, obeeify, daytime activ’ ) andto an impairrd leftventriculardiastolicrelaxation. Ksy%’ orals: hypertension.ambulatoryBP monitoring. circadianvariation. menopau~