Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT

Abstract

BackgroundThe menstrual cycle is regulated by reproductive hormones such as estrogen which has been implicated in the pathogenesis of hypertension and is associated with obesity. However, to date there has scant study of hypertension in relation to menstrual characteristics and abnormalities. We hypothesize that adverse menstrual characteristics are associated with an increase the prevalence of hypertension and that this relationship is exacerbated by obesity.MethodsOur study leverages 178,205 healthy female participants (mean age = 29) in a population-based cross-sectional study in Tianjin, China. Menstrual characteristics including menstrual cycle length and regularity, menstrual bleeding length, menstrual blood loss and dysmenorrhea were assessed by self-reported questionnaires, and hypertension was diagnosed by physician. Multiple logistic regression models were used to assess the relationships between menstrual characteristics and hypertension.ResultsNormal length menstrual cycle (OR = 1.21, 95% CI: 1.03–1.41), oligomenorrhea (OR = 1.54, 95% CI: 1.12–2.07), irregular cycle (OR = 1.54, 95% CI: 1.22–1.93), and light menstrual blood loss (OR = 1.36, 95% CI: 1.06–1.72) were associated with hypertension among women who are overweight or obese, but not among women who are normal weight. Longer menstrual bleeding duration (OR = 1.44, 95% CI: 1.24–1.67) and dysmenorrhea were associated with increased prevalence of hypertension (OR = 1.20, 95% CI: 1.14–1.41) in all young women.ConclusionsThe prevalence of hypertension is higher among women with menstrual abnormalities, and this association is modified by overweight and obesity.

Adipokines: A gear shift in puberty

“…From an evolutionary point of view, body fat increases in mammalian females during puberty onset, and it highlights the need to guarantee a healthy pregnancy, offspring, and maternal survival . An improper level of body fat, sex‐hormones, and neuroendocrine alterations can evolve in menstrual dysfunction, for instance, in women with severe obesity or in women with anorexia nervosa . Importantly, body fat distribution, particularly body fat localized predominantly on the gluteofemoral fat depots, is profoundly associated with start of menarche, more than amount of total body fat .…”

The Relationship between Pain and Vascular Function Biomarkers in Dysmenorrheal University Students

“… 7 Attempts have been made in previous studies to understand if dysmenorrhea predisposes women to vascular complications such as high blood pressure, hypertension, and stroke, but whether the severity of dysmenorrhea correlates to the susceptibility to these vascular complications remained unexplained. 8 9 10 Based on this, we conducted this study using female university students to first establish the reliability of a pain biomarker, contactin 1, for the assessment of the severity of dysmenorrhea, by correlating with the NRS-11 pain scale of each participant, and also correlated with the biomarkers of vascular health; the vascular cell adhesion molecule 1 and angiotensin II.…”

Stroke risks in women with dysmenorrhea by age and stroke subtype

“…Hormonal balance can be altered in women with abnormal menstrual patterns and may mediate the risk of hypertension. Estrogen can play a role in vasodilator function [4,5], while androgens may contribute to the pathogenesis of hypertension [6,7]. Furthermore, women with endometriosis are at an increased risk of hypertension and dysmenorrhea [8,9], and blood pressure may thus be affected in dysmenorrheal women.…”