CARDIOVASCULAR COMORBIDITIES AND CARDIO-RENO-METABOLIC RISK FACTORS IN MENOPAUSAL WOMEN EHUH 2 STUDY

Objective: Prevalence of arterial hypertension (AH) and cardiovascular (CV) morbidity and mortality increased in menopausal women. Our aim was to examine the differences in CV profiles between women with AH and normotensive (NT) women in general population. Design and method: This cross-sectional study was part of the EH–UH 2 survey. Out of total of 2021 participants included by random selection from the general adult population, this study involved 622 menopausal women with AH (N=404) and NT (N=218). Participants completed a survey on CV morbidity, and fasting blood and urine samples were collected for various cardio-reno-metabolic biomarkers and risk factors. Results: AH women were older (65.9 vs. 62.2, p>0.05) with no differences in average age of menopause onset (51 years). Compared to NT women, women with AH showed higher prevalence of of ischemic stroke (3.9% vs. 0.5%; p = 0.02), myocardial infarction and atrial fibrillation (2.2% vs. 1.8%, 4.7% vs. 2.2%;p>0.05 for both), diabetes (21.3% vs. 10.6% p=0.004), obesity and visceral obesity (43.5% vs. 26.1%; 83.4% vs. 64.5%;p<0.001 for both), thyroid disease (14.1% vs. 9.6%; p>0.05) with no differences in prevalence heart failure and chronic kidney disease (0.9% vs 0.9%; 4.0% vs. 4.1%; p> 0.05 for both). AH women had significantly elevated levels of total cholesterol, LDL cholesterol, triglycerides, non-HDL cholesterol, cholesterol/HDL ratio, ApoB/ApoA-I and Apo compared to NT women. Serum urate, fasting blood glucose, and HOMA-IR were significantly higher in AH women who also showed elevated NT-proBNP (200.2 vs. 141.6 pg/mL) and hs-troponin I (5.93 vs. 5.44 ng/L). There were no differences in eGFR (81.1vs 84.9), but ACR was significantly higher in AH women (51.9 vs. 24.3). Conclusions: Hypertensive women showed a higher rate of CV morbidity. They were more obese (visceral) with more atherogenic lipid profile, higher urate values and insulin resistance which are linked to the endothelial damage (high ACR) and subclinical heart dysfunction. This elevated risk, driven by a combination of metabolic, inflammatory, and vascular factors, underscores the importance of tailored interventions to reduce CV disease burden and prevention of CV morbidity and mortality.