This Article Full Text Full Text (PDF) All Versions of this Article: 47/6/1168    most recent 01.HYP.0000218857.67880.75v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schulman, I. H. Articles by Martin, R. Search for Related Content PubMed PubMed Citation Articles by Schulman, I. H. Articles by Martin, R. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Hysterectomy Menopause Hazardous Substances DB SODIUM CHLORIDE Related Collections Risk Factors Other hypertension

(Hypertension. 2006;47:1168.)
© 2006 American Heart Association, Inc.

Original Articles

Surgical Menopause Increases Salt Sensitivity of Blood Pressure

Ivonne Hernandez Schulman; Pedro Aranda; Leopoldo Raij; Maddalena Veronesi; Francisco J. Aranda; Remedios Martin

From the Nephrology and Hypertension Section (I.H.S., L.R.), Veterans Affairs Medical Center, Division of Nephrology and Hypertension and Vascular Biology Institute, University of Miami Miller School of Medicine, FL; Hypertension and Vascular Risk Unit (P.A., F.J.A., R.M.), University General Hospital, Malaga, Spain; and Department of Internal Medicine (M.V.), University of Bologna, Bologna, Italy.

Correspondence to Leopoldo Raij, Nephrology-Hypertension Section, Veterans Affairs Medical Center, 1201 NW 16 St (Room A-1009), Miami, FL 33125. E-mail LRaij{at}med.miami.edu

Salt sensitivity of blood pressure is associated with an elevated risk of developing hypertension (HTN) and is an independent risk factor for cardiovascular disease. The prevalence of HTN increases after menopause. The aim of this study was to investigate prospectively whether the loss of ovarian hormones increases the occurrence of salt sensitivity among healthy premenopausal women. We enrolled 40 normotensive, nondiabetic women (age 47.2±3.5), undergoing hysterectomy–oophorectomy for nonneoplastic processes and not on hormone replacement, to determine the effect of changes in sodium intake on blood pressure the day before and subsequently 4 months after surgical menopause. Salt loading was achieved using a 2-L normal saline infusion and salt depletion produced by 40 mg of intravenous furosemide. A decrease >10 mm Hg in systolic blood pressure between salt loading and salt depletion was used to define salt sensitivity. Before and after menopause, salt-sensitive women exhibited higher waist/hip and waist/thigh ratios (P<0.01). Although all of the women remained normotensive, the prevalence of salt sensitivity was significantly higher after surgical menopause (21 women; 52.5%) than before (9 women; 22.5%; P=0.01), because 12 (38.7%) salt-resistant women developed salt sensitivity after menopause. In summary, we demonstrated that the prevalence of salt sensitivity doubled as early as 4 months after surgical menopause, without an associated increase in blood pressure. Epidemiological studies indicate that development of HTN may not occur until 5 to 10 years after menopause. The loss of ovarian hormones may unmask a population of women prone to salt sensitivity who, with aging, would be at higher risk for the subsequent development of HTN and cardiovascular disease.

Key Words: risk factors • hormones • gender • cardiovascular diseases

This article has been cited by other articles:

				M. Barton and M. R. Meyer Postmenopausal Hypertension: Mechanisms and Therapy Hypertension, July 1, 2009; 54(1): 11 - 18. [Full Text] [PDF]

				Q. Fu, W. Vongpatanasin, and B. D. Levine Neural and Nonneural Mechanisms for Sex Differences in Elderly Hypertension: Can Exercise Training Help? Hypertension, November 1, 2008; 52(5): 787 - 794. [Full Text] [PDF]

				M. Coylewright, J. F. Reckelhoff, and P. Ouyang Menopause and Hypertension: An Age-Old Debate Hypertension, April 1, 2008; 51(4): 952 - 959. [Full Text] [PDF]

				L. Groban, L. M. Yamaleyeva, B. M. Westwood, T. T. Houle, M. Lin, D. W. Kitzman, and M. C. Chappell Progressive Diastolic Dysfunction in the Female mRen(2).Lewis Rat: Influence of Salt and Ovarian Hormones J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2008; 63(1): 3 - 11. [Abstract] [Full Text] [PDF]

				C. Maric Mechanisms of Fetal Programming of Adult Hypertension: Role of Sex Hormones Hypertension, October 1, 2007; 50(4): 605 - 606. [Full Text] [PDF]

				K. Tsuda Surgical Menopause, Salt Sensitivity, and NO Bioavailability in Women Hypertension, September 1, 2006; 48(3): E12 - E12. [Full Text] [PDF]

				Minerva BMJ, June 10, 2006; 332(7554): 1400 - 1400. [Full Text] [PDF]

				M. H. Weinberger Estrogens, Salt, Blood Pressure, and Cardiovascular Disease in Women: How Do We Interpret the Data? Hypertension, June 1, 2006; 47(6): 1049 - 1050. [Full Text] [PDF]