Features of arterial hypertension in postmenopausal women with abdominal obesity: The role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness

Background. Despite overall efforts, arterial hypertension remains one of the most significant medical and social problems. The risk of developing arterial hypertension is tripled in obese individuals compared with people who have normal body weight. According to clinical studies, individual biochemical markers can be predictors of initiation of remodeling processes in systems at a preclinical level. Endothelial dysfunction is the initial stage in the development of atherosclerosis. Mechanisms of the vascular inflammatory response in arterial hypertension with obesity can be considered a factor that largely determines the onset and course of the disease, a cause of its aggravation, development, and progression. Cardiovascular risk factors, genetic predisposition, deficit of sex hormones, and aging affect the endothelium function.

Aim. To study specifics of hypertension in postmenopausal women with abdominal obesity and to evaluate the role of inflammatory response markers, leptin, and female sex hormones in the pathogenesis of vascular wall stiffness.

Material and Methods. The study included 164 patients divided into three groups. Group 1 consisted of 42 healthy women aged 44.43 ± 14.26 years; group 2 comprised 62 hypertensive women aged 60.69 ± 7.09 years; group 3 comprised 60 hypertensive women with abdominal obesity aged 57.24 ± 7.40 years. Patients of all groups received 24-hour blood pressure monitoring, sphygmography, and assessment of sex hormones, lipids, inflammatory, and biochemical parameters in blood serum.

Results. Results of analysis showed that patients of group 3 had significantly higher blood pressure compared with that in group 2. Higher pulse wave velocity was observed in women of group 2. Groups 2 and 3 had lower levels of sex hormones and significant increases in the levels of inflammatory markers compared with those in control group. Multiple multidirectional correlations between the studied parameters were revealed.

Conclusions. Features of hypertension in postmenopausal women with obesity consist in a systolic-diastolic variant of hypertension, an increase in systolic blood pressure variability at night, an increase in diastolic blood pressure during the daytime, and increases in systolic and diastolic blood pressure at night. The method of logistic regression allowed to identify biochemical markers that determine the elastic properties of the vascular wall in this category of patients, namely: leptin, highsensitivity C-reactive protein, and endothelin-1. 

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