玻利维亚亚马逊地区觅食园艺师在衰老和更年期期间的血压变化

摘要(中文译文)

心血管疾病（CVD）是全球女性死亡的首要原因，而绝经与发病率和死亡率的升高相关。绝经对血压的总体影响仍无定论，现有证据主要基于工业化人群的数据。为填补这一空白，我们研究了Tsimane觅食-园艺人群中的绝经、血压与高血压之间的关联，并将结果与美国全国代表性样本进行比较，以评估绝经相关血压变化的人群差异。我们分析了Tsimane女性和男性（n=5,570；n=18,676；年龄15-92岁）以及美国国家健康与营养调查（NHANES）参与者（n=6,861；年龄16-80岁）的数据。我们采用线性回归模型评估年龄和人群对绝经相关收缩压（SBP）和舒张压（DBP）的影响，采用逻辑回归模型分析高血压和2期高血压，并进行雌二醇中介分析。绝经后SBP的年龄轨迹更高（b=0.002，p<0.001），DBP轨迹更低（b=-0.004，p<0.001）。与美国女性相比，Tsimane女性的SBP随年龄增长上升更快（b=0.001，p=0.021），而DBP下降幅度较小（b=0.003，p<0.001）。与绝经前女性相比，绝经后个体随年龄增长患高血压的比值比更低。雌二醇未中介绝经对血压的影响。尽管CVD风险环境差异很大，我们在两个人群中均发现绝经与血压之间存在相似的关联。然而，Tsimane女性绝经后血压随年龄的变化略有不同。这些结果表明，绝经后血压变化可能具有普遍性，但绝经前的CVD风险环境可能影响绝经后的CVD风险结局。

Abstract

Cardiovascular disease (CVD) is the leading cause of death for women globally, and menopause is associated with elevated morbidity and mortality. The total impact of menopause on blood pressure remains inconclusive, with evidence largely based on data from industrialized populations. To address this gap, we examined associations between menopause, blood pressure, and hypertension among Tsimane forager-horticulturalists and compared results against a nationally representative US sample to assess population-level differences in blood pressure with menopause. We analyzed data from female and male Tsimane (n = 5,570; n = 18,676; ages 15-92) and US National Health and Nutrition Examination Survey participants (NHANES; n = 6,861; ages 16-80). We applied linear regression models to assess age and population effects on systolic (SBP) and diastolic blood pressure (DBP) with menopause, logistic regression models for hypertension and stage 2 hypertension, and mediation analyses with estradiol. SBP age trajectories were higher (b = 0.002, p < 0.001) and DBP trajectories lower (b = -0.004, p < 0.001) following menopause. Compared to US women, Tsimane women's SBP increased more quickly with age (b = 0.001, p = 0.021), while DBP decreased less dramatically (b = 0.003, p < 0.001). Postmenopause individuals had lower odds of hypertension with age compared to premenopausal women. Estradiol did not mediate blood pressure effects of menopause. We found similar associations between menopause and blood pressure in both populations, despite widely differing CVD risk environments. However, Tsimane women showed slightly different pressure changes with age postmenopause. These results indicate blood pressure change postmenopause may be universal, but premenopause CVD risk environments may impact postmenopause CVD risk outcomes.

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