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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the middle age of a woman's life cycle, several health changes and problems occur. Therefore, middle aged women must manage their health and maintain quality life by coping with bodily changes. However, today there is not enough research and health programs for middle aged women. Data from the study will be used for health promotion program development of middle aged women. Data was collected from January 21 to 24, 1995 by telephone interview. Four hundred middle aged women between 40 and 59 years old and living in Chon Ju City were interviewed. The results of this study were as follow: 1. Frequency rate of menopausal symptoms was 38.4%. The most serious menopausal symptom was psychosomatic symptom. Mean score orders of experienced symptoms were back pain, joint pain (1.80), nervousness (1.80), general weakness (1.67). 2. The most important problems as perceived by the clients were children (45.8%), health (24.0%) and economics (7.8%). The most serious health problems were concerning the muscle-skeletal system (45%) such as arthritis, spinal disk problems and osteoporosis. Adult diseases (14.5%) such as hypertension and diabetes were also health concerns. Health management activities reported were exercise (22.5%), social activity (12%) and inactivity (53%). 33% of clients were interested in health groups and they wanted a program of health education, exercise and social activity to be provided. 3. General characteristic variables were significantly related to the level of menopausal symptoms as follows: age (t = -2.06, p = 0.040), status of marriage (t = -3.56, p = 0.000), educational level (F = 4.35, p = 0.05) and menopausal status (t = 4.37, p = 0.000).
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PMID:[A study on menopausal symptoms and health needs among middle aged women]. 855 27

Combining the wealth of epidemiological, metabolic and recent mechanistic data, it would appear biologically plausible that HRT, either oestrogen alone or in combination with progestogen, is cardioprotective. Further research is required, as information is lacking on cardiovascular effects of HRT instigated at an older age. There is a need to identify cardiovascular benefit, indirect and/or direct, of combined oestrogen/progestogen therapy using randomized trials. The various progestogen types and doses also need to be investigated. Studies are also required to investigate the effect of HRT use in higher risk patients with established CVD. There is scant information on the effect of HRT on blood pressure of patients with hypertension. Cardiovascular risk factor profiles and incidence surveys need to be conducted in developing countries to characterize their female population and to identify the prevalence of CVD; this needs to be undertaken before widespread recommendations on CVD prevention and the role of HRT can be made. If HRT is to be used effectively in the future treatment of heart disease in women these questions need to be addressed. At present HRT is indicated for the relief of menopausal symptoms and the prevention of osteoporosis. In women without these indications, ORT may be recommended in those who have had a premature menopause, and possibly in those who have established CHD or who are at high risk of developing CHD. It is too early to suggest a blanket recommendation for the use of HRT in the treatment of the symptoms of women with established CVD, but HRT after the menopause may at least be safely used in the secondary prevention of CHD.
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PMID:The menopause and the cardiovascular system. 893 7

To obtain information to guide future health care planning, data from government and other sources on the demographic and medical characteristics of menopausal Taiwanese women were reviewed. The average age at menopause, according to a 1995-96 study of 386 menopausal women in Taipei, is 49.5 +or- 2.3 years. In 1994, women aged 50 years and over comprised 18.3% of Taiwan's female population and 8.9% of the total population. 68% of menopausal women in the 1995-96 study reported lower back pain; other common symptoms included fatigue (59%), decreased memory (55%), vaginal dryness (50%), hot flashes (49%), insomnia (46%), loss of libido (46%), dry skin (41%), and depression (40%). After menopause, the prevalence of hypertension and coronary heart disease becomes higher among women than men. In addition, bone mineral density decreases markedly and 19.8% of women 65 years of age and over have experienced vertebral fractures. About 60% of malignant neoplasms diagnosed in 1992 involved women aged 50 years and older. By age 60 years, women's risk of cancer begins to increase substantially. An estimated 80% of Taiwanese women initiate hormone replacement therapy for relief of menopausal symptoms, prevention of cardiovascular disease, and prevention and treatment of osteoporosis. Since 30% of menopausal women in Taiwan are currently widowed or unmarried, there is a need to design programs that offer psychosocial support as well as comprehensive medical care.
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PMID:Demographic characteristics and medical aspects of menopausal women in Taiwan. 934 80

The present study evaluated the short-term effects of percutaneous 17 beta-estradiol on blood pressure, metabolic profile and hormonal levels in postmenopausal women with systemic arterial hypertension. After a wash-out period of 15 days, 10 hypertensive patients were treated with guanabenz acetate to control blood pressure, followed by 17 beta-estradiol in the form of hydroalcoholic gel administered for 21 of 28 days of each cycle, for 3 cycles. Patients were evaluated before, during and 2 months after estrogen administration. Systolic and diastolic blood pressure or heart rate did not present any significant change in any patient when compared to those periods with the antihypertensive drug only (pretreatment period and 60 days after estrogen therapy was discontinued). Plasma biological markers of hepatic estrogenic action (plasma renin activity, antithrombin III, triglycerides, total cholesterol and lipoproteins) also remained unchanged during the study. Hormone treatment was effective, as indicated by the relief of menopausal symptoms, a decrease in FSH levels (73.48 +/- 27.21 to 35.09 +/- 20.44 IU/l, P < 0.05), and an increase in estradiol levels (15.06 +/- 8.76 to 78.7 +/- 44.6 pg/ml, P < 0.05). There was no effect on LH (18.0 +/- 9.5 to 14.05 +/- 8.28 IU/l). Hormone levels returned to previous values after estrogen treatment was discontinued. The data indicate that short-term percutaneous 17 beta-estradiol replacement therapy, at the dose used, seems to be a safe hormone therapy for hypertensive menopausal women. Nevertheless, a controlled, prospective, randomized clinical assay with a larger number of subjects is needed to definitely establish both the beneficial and harmful effects of hormone replacement therapy in hypertensive women.
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PMID:Percutaneous 17 beta-estradiol replacement therapy in hypertensive postmenopausal women. 945 63

Estrogen replacement therapy (ERT) is used not only for the short-term control of menopausal symptoms but long-term for disease prevention. This study examined the influence of selected clinical conditions on the use of ERT and the duration of ERT use among women enrolled in a state Medicaid program. We identified 60,531 women, aged >/=45 years, who were enrolled in Maryland Medicaid continuously for at least 2 of 3 years. ERT use was determined through prescription claims submitted for reimbursement. The presence or risk of selected clinical conditions (e.g., osteoporosis, heart disease, estrogen-sensitive cancers) was determined by screening Medicaid claims files for related diagnoses, procedures, or prescription claims. Multiple logistic regression was used to model ERT use, and proportional hazards regression was used to model duration of use. Fourteen percent of these women filled an ERT prescription, with use varying by age, race, and place of residence. Oral dosage forms were the most popular (80.8%), followed by vaginal cream or ring (22.2%), and transdermal patch (7.3%). In adjusted models, osteoporosis, heart disease, hypertension, hyperlipidemia, diabetes, ovarian cancer, and thromboembolic disease were positively associated and dementia and breast cancer were negatively associated with ERT use. None of these medical conditions predicted the duration of estrogen therapy. Use of ERT was very low among these women despite coverage of prescription medications, and the presence of clinical indications had no influence on the length of therapy among these women despite known benefits for long-term preventive therapy.
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PMID:Clinical correlates of estrogen replacement therapy use and duration of use among medicaid recipients. 1170 94

Endometrial response to natural estradiol and low-dose vaginal progesterone replacement therapy was evaluated in 20 postmenopausal women with chronic, mild-to-moderate hypertension. A cyclic hormone replacement therapy (HRT) regimen was used (21/28 days) with percutaneous estradiol (1.5 mg/day) and vaginal micronized progesterone (100 mg/day). Menopausal symptoms decreased and estradiol concentrations increased substantially and remained in the physiological range throughout treatment. Serum gonadotropin concentrations decreased significantly (p < 0.001, Friedman's ANOVA). Bone mineral density increased by 2.1% (p = 0.029) only at the lumbar spine. Endometrial thickness remained unchanged. Breakthrough bleeding or spotting occurred in 18% of cycles in the first 3 months of HRT, 30% in months 4-9 and 22% in months 10-12. Withdrawal bleeding occurred in 40% of cycles in the first 3 months and decreased to 25% in months 10-12. At month 12, there were 11 women with amenorrhea due to endometrial atrophy. Nine women had active endometria (proliferative or secretory) and thus reported vaginal bleeding. No severe bleeding, hyperplasia, or carcinoma was found. Vaginal bleeding was tolerated, and no subject withdrew from the study. Results suggest that this regimen confers endometrial protection and is well tolerated, and can therefore safely be used for at least 1 year by postmenopausal women with hypertension and menopausal symptoms.
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PMID:Endometrial response to a cyclic regimen of percutaneous 17beta-estradiol and low-dose vaginal micronized progesterone in women with mild-to-moderate hypertension. 1450 77

Postmenopausal women in Western societies are conscious of breast cancer as a potential cause of death and ill health, which they wish to avoid with the advice of their doctors. Yet many factors that predispose women to the development of cancer will have been laid down before the menopause, in their genetic makeup or during their adolescent years. Even in middle age it is important to take account of the intrinsic level of risk, and to give women advice tailored to their own individual risk level. This results from their family history, previous diseases such as benign breast disease, and previous treatment for breast cancer or Hodgkin's disease. For those at the highest level of risk, strategies will include regular screening, prophylactic mastectomy, and the use of chemoprevention agents, such as tamoxifen. These women should avoid hormone replacement therapy (HRT) and control their menopausal symptoms and osteoporosis through the use of other agents now available - venlafaxine for menopausal symptoms and bisphosphonates for osteoporosis. Raloxifene is an agent under trial that may be valuable for breast cancer control as well as for osteoporosis. Women at standard population risk will require less robust preventive strategies, which will include screening and lifestyle modification. Their decisions regarding HRT should now be modified by recent evidence of associated risks. Recent studies show that tibolone causes less mammographic density and has a lower relative risk of breast cancer than combined estrogen/progestogen preparations. There is limited evidence that controlling obesity, participating in exercise and adopting a diet low in fats and high in fruit and vegetables will alter risk at this age. These precautions will, however, reduce the risk of other diseases common in this age group, such as hypertension, heart disease, stroke, and type 2 diabetes mellitus. Alcohol, even in small amounts, is a risk factor for breast cancer. Given the cardioprotective effect of moderate alcohol intake, advice on alcohol must reflect the individual relative risk of cardiovascular disease and breast cancer. Personal risk assessment is relevant for all women. Screening and a healthy lifestyle are worthwhile approaches for all, with the more aggressive approaches such as chemoprevention and prophylactic surgery reserved for those who have substantially elevated levels of risk. Once the menopause has passed, screening is probably the most effective evidence-based tool for breast cancer control by early diagnosis.
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PMID:Strategies for managing breast cancer risk after the menopause. 1533 Jun 77

Heart disease is the major health issue facing women in the United States today. Yet, less than 50% of women are aware cardiovascular disease is a health problem. Atherosclerosis begins in childhood and lipid streaks have been identified in girls ages 15-19 in the abdominal aorta and the right coronary artery. Risk factors for cardiovascular disease in women include smoking, diabetes, hypertension, lipid disorders, and menopause. Observational studies have reported a 30-50% reduction in cardiovascular events when estrogen was administered to younger women for menopausal symptoms, yet randomized trials in older patients have failed to show benefit with hormonal replacement therapy. Recent studies have reported preservation of lipid and vascular vasodilatation with low-dose conjugated equine estrogens (CEE) in women and an absence of inflammatory and clotting changes that were observed in high-dose CEE. Recommendations for reducing cardiovascular risk in postmenopausal women include smoking cessation, regular exercise, and weight control. Should hormone therapy be continued beyond management of menopausal symptoms and treatment for osteoporosis, a statin drug should be added to eliminate future cardiovascular complications. Future research will examine low-dose hormonal therapy, earlier administration after menopause, newer agents, and routes of estrogen administration.
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PMID:Hormones and coronary atherosclerosis in women. 1554 92

Hypertension is one of the most important risk factors for the development of cardiovascular disease. The prevalence of hypertension increases with age and also after the menopause; therefore, blood pressure monitoring and effective control of elevated blood pressure are very important in postmenopausal women. The knowledge that aldosterone is a dual cardiovascular and endocrine hormone has blurred the once distinct boundary between gynecology and cardiovascular medicine. Aldosterone plays a major role in salt and water homeostasis, but also binds to mineralocorticoid receptors in the cardiovascular system, leading to structural and functional changes and consequent organ damage. Highly selective aldosterone blockade via the mineralocorticoid receptor has long-term antihypertensive effects. Drospirenone is a novel progestogen with aldosterone receptor antagonism (PARA), and therefore has antihypertensive effects through reduced salt and water retention. A new hormone therapy that combines 17beta-estradiol with drospirenone has been shown in several clinical studies to have a blood pressure-lowering effect in postmenopausal women with elevated blood pressure, in addition to effectively relieving symptoms of the menopause. These findings suggest a potential additional benefit on the cardiovascular system for the drospirenone/17beta-estradiol combination in the treatment of women with menopausal symptoms and elevated blood pressure.
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PMID:Drospirenone with 17beta-estradiol in the postmenopausal woman with hypertension. 2208 36

Hypertension in middle-aged or elderly women is often accompanied with various symptoms, which may be related to climacteric. The symptoms of post-menopausal women are suggested to be derived in part from instability of the sympathetic nerve system due to a low estrogen state. An angiotensin-receptor blocker, candesartan cilexetil (candesartan), is known to suppress sympathetic nerve activity by inhibiting the renin-angiotensin system in the brain, suggesting that it may be effective for ameliorating these symptoms. The aim of this study was to elucidate whether candesartan improves menopausal symptoms in hypertensive women. A total of 69 female patients, aged 40 years or older, who had hypertension and various menopausal-like symptoms, were recruited from 39 centers to participate in this study. Patients were prescribed candesartan 4 to 8 mg/day (average dose 7.2 mg/day), alone or in addition to current antihypertensive medications. We interviewed patients in regard to their menopausal symptoms and scored them using the Simplified Menopausal Index (SMI). During the 12-month observation period, significant decreases were seen in both blood pressure (157+/-21/85+/-11 to 141+/-18/77+/-12 mmHg, p<0.001) and SMI (29+/-18 to 18+/-7, p<0.001), although the heart rate did not change. The percentage of decrease in SMI was correlated with that in systolic blood pressure (r=0.43, p<0.001). Candesartan may be an effective antihypertensive agent to relieve menopausal-like symptoms in middle-aged or elderly hypertensive women.
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PMID:Effects of candesartan for middle-aged and elderly women with hypertension and menopausal-like symptoms. 1737 73


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