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Resistive index of renal artery and blood pressure in postmenopausal women

      Abstract

      Causal association between perimenopausal changes and symptoms and disease is commonly accepted even if not definitely explained. Resistive index (RI) of renal artery assessed by Doppler echography is related to renal function and systemic circulatory adaptation in patients with chronic renal failure and hypertension. Echocardiographic measurement of left ventricular myocardial mass (LVMM) is a useful tool for assessing effects of arterial hypertension on heart. Aim of the study was to assess RI in normotensive postmenopausal women and relationship, if any, with blood pressure and LVMM. We studied 28 normotensive, non-obese postmenopausal women, age 52.21±5.40 years, with normal creatinine clearance. Renal colour-Doppler echography was performed assessing intra-parenchimal renal artery mean velocity (mVRA) and intra-parenchimal RI [(peak systolic velocity−end diastolic velocity)/peak systolic velocity]. Echocardiography was performed as well. RI of intra-parenchimal renal artery is 0.67±0.05 and it shows correlations vs. diastolic blood pressure (r=0.41; P<0.03) and vs. mean BP (r=0.47; P<0.01). LVMM has correlation (r=0.41; P>0.03) with RI. Age, body weight, body mass index, menarche age, fertility years and postmenopausal years do not show correlation with RI. Heart rate, creatinine clearance, hemoglobin, serum albumin do not show any correlation with RI. Higher RI is associated with alcohol intake, liver steatosis, biliary gallstones and family history of diabetes mellitus, but not with postmenopausal years, unrespective of surgical or non-surgical menopause. Among echocardiographic measurements only LVMM is correlated with RI; mVRA does not show correlation. LVMM and BP do not show other independent correlation except that the one already reported vs. RI. RI, as a pathophysiological measurement whose increase preludes to arterial hypertension, could help to ascertain perimenopausal women at risk for arterial hypertension and left ventricular hypertrophy, but does not seem directly associated with the loss of ovarian function.

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      References

        • Greendale G.A.
        • Lee N.P.
        • Arriola E.R.
        The menopause.
        Lancetww. 1999; 353: 571-580
        • Brochier M.L.
        • Arwidson P.
        Coronary heart disease risk factors in women.
        Eur. Heart J. 1998; 19: A45-52
        • Mendelsohn M.E.
        • Karas R.H.
        The protective effects of estrogens on the cardiovascular system.
        N. Engl. J. Med. 1999; 340: 1801-1811
        • Yaffe K.
        • Sawaya G.
        • Lieberburg I.
        • Grady D.
        Estrogen therapy in postmenopausal women: effects on cognitive function and dementia.
        J. Am. Med. Assoc. 1998; 279: 688-695
        • Nordin B.E.
        • Need A.G.
        • Steurer T.
        • Morris H.A.
        • Chatterton B.E.
        • Horowitz M.
        Nutrition, osteoporosis and aging.
        Ann. NY Acad. Sci. 1998; 854: 336-351
        • Grodstein F.
        • Stampfer M.J.
        • Colditz G.A.
        • Willett W.c
        • Manson J.E.
        • Joffe M.
        • et al.
        Postmenopausal hormone therapy and mortality.
        N. Engl. J. Med. 1997; 25: 1769-1775
        • Herrington D.M.
        The HERS trial results: paradigms lost?.
        Ann. Intern. Med. 1999; 131: 463-466
        • Herrington D.M.
        • Reboussin D.R.
        • Klein K.P.
        • et al.
        The estrogen replacement and atherosclerosis (ERA) study: study design and baseline characteristics of the cohort.
        Contr. Clin. Trials. 2000; 21: 257-285
        • Herrington D.M.
        • Reboussin D.M.
        • Brosnihan K.B.
        • et al.
        Effects of estrogen replacement on the progression of coronary–artery atherosclerosis.
        N. Engl. J. Med. 2000; 343: 522-529
        • Hulley S.
        • Grady D.
        • Bush T.
        • et al.
        Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women.
        J. Am. Med. Assoc. 1998; 280: 605-613
        • Grady D.
        • Applegate W.
        • Bush T.
        • Furberg C.
        • Riggs B.
        • Hulley S.B.
        The heart and estrogen/progestin replacement study (HERS): design, methods, and baseline characteristics.
        Contr. Clin. Trials. 1998; 19: 314-335
        • Staessen J.A.
        • Ginocchio G.
        • Thijs L.
        • Fagard R.
        Conventional and ambulatory blood pressure and menopause in a prospective population study.
        J. Hum. Hypertens. 1997; 11: 507-514
        • Amigoni S.
        • Morelli P.
        • Parazzini F.
        • Chatenoud L.
        Determinants of elevated blood pressure in women around menopause: results from a cross-sectional study in Italy.
        Maturitas. 2000; 15: 25-32
        • Schillaci G.
        • Verdecchia P.
        • Borgioni C.
        • Ciucci A.
        • Porcellati C.
        Early cardiac changes after menopause.
        Hypertension. 1998; 32: 769-769
        • Petersen L.J.
        • Petersen J.R.
        • Ladefoged S.D.
        • Mehisen J.
        • Jensen H.E.
        The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure.
        Nephrol. Dial. Transplant. 1995; 10: 2060-2064
      1. Sahn DJ, De Maria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; W1072–83.

        • Schiller N.B.
        • Shah P.M.
        • Crawford M.
        • DeMaria A.
        • Devereux R.
        • Feigenbaum H.
        • et al.
        Recommendations for quantitation of the left ventricle by two dimensional echocardiography: American Society of Echocardiography Committees.
        J. Am. Soc. Echo. 1989; 55: 358-367
        • Devereux R.B.
        • Reichek N.
        Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method.
        Circulation. 1977; 55: 613-618
        • Becker F.
        The value of the Planiol and Pourcelot resistance index in the common carotid artery in narrow stenosis at the origin of the internal carotid artery.
        J. Mal. Vasc. 1982; 7: 229-231
        • Knapp R.
        • Plotzeneder A.
        • Frauscher F.
        • Helweg G.
        • Judmaier W.
        • zur Nedden D.
        • et al.
        Variability of Doppler parameters in the healthy kidney: an anatomic-physiologic correlation.
        J. Ultrasound Med. 1995; 14: 427-429
        • Norris C.S.
        • Barnes R.W.
        Renal artery flow velocity analysis: a sensitive measure of experimental and clinical renovascular resistance.
        J. Surg. Res. 1984; 36: 230-236
        • Veglio F.
        • Frascisco M.
        • Melchio R.
        • Provera E.
        • Rabbia F.
        • Oliva S.
        • et al.
        Assessment of renal resistance index after captopril test by Doppler in essential and renovascular hypertension.
        Kidney Int. 1995; 48: 1611-1616
        • Stevens P.E.
        • Gwyther S.J.
        • Hanson M.E.
        • Boultbee J.E.
        • Kox W.J.
        • Phillips M.E.
        Non invasive monitoring of renal blood flow characteristics during acute renal failure in man.
        Intensive Care. Med. 1990; 16: 153-158
        • Stevens P.E.
        • Gwyther S.J.
        • Hanson M.E.
        • Woodrow D.F.
        • Phillips M.E.
        • Boultbee J.E.
        Interpretation of duplex Doppler ultrasound in renal transplants in early postoperative period.
        Nephrol. Dial. Transplant. 1993; 8: 255-258
        • Rasmussen K.
        • Pedersen E.
        Doppler ultrasound in the diagnosis of renal allograft rejection and in monitoring the effect of treatment.
        Scand. J. Clin. Invest. 1990; 50: 56-61
        • Quarto di Palo F.
        • Rivolta R.
        • Elli A.
        • Castagnone D.
        Relevance 24 of resistive index ultrasonographic measurement in renal transplantation.
        Nephron. 1996; 73: 195-200
        • Kim S.H.
        • Kim W.E.
        • Choi B.I.
        • Kim C.W.
        Duplex Doppler US in patients with medical renal disease: resistive index vs. serum creatinine level.
        Clin. Radiol. 1992; 45: 85-87
        • Pontremoli R.
        • Viazzi F.
        • Martinoli C.
        • Ravera M.
        • Nicolella C.
        • Berruti V.
        • et al.
        Increased renal resistive index in patients with essential hypertension: a marker of target organ damage.
        Nephrol. Dial. Transplant. 1999; 14: 360-365
        • Ozsener S.
        • Sagol S.
        • Oztekin K.
        • Biligin O.
        The effect of continuous combined oral estradiol and norethisterone on the renal and internal carotid artery pulsatility indices in postmenopausal women.
        Int. J. Gynaecol. Obstet. 2000; 69: 281-282
        • Caruso G.
        • Catalano D.
        • Carpinteri G.
        • Di Fazzio S.
        • Mazzone O.
        Relationship among volume of paracentesis, portal blood flow and renal resistive index, evaluated by duplex Doppler ultrasonography in cirrhosis with tense ascites.
        Rec. Progr. Med. 1996; 87: 164-166
        • Catalano D.
        • Caruso G.
        • DiFazzio S.
        • Carpinteri G.
        • Scalisi N.
        • Trovato G.M.
        Portal vein pulsatility ratio and heart failure.
        J. Clin. Ultrasound. 1998; 26: 27-31
        • Villecco A.S.
        • de Aloysio D.
        • Pilati G.
        • Mauloni M.
        • Roncuzzi A.
        • Bottiglioni F.
        • et al.
        Non-invasive 24-hr monitoring of high blood pressure in climacteric outpatients.
        Maturitas. 1987; 9: 267-274
        • Beljic T.
        • Babic D.
        • Marinkovic J.
        • Prelevic G.M.
        The effect of hormone replacement therapy on diastolic left ventricular function in hypertensive and normotensive postmenopausal women.
        Maturitas. 1998; 29: 229-238
        • van der Mooren M.J.
        • Mijatovic V.
        • van Baal W.M.
        • Stehouwer C.D.
        Hormone replacement therapy in postmenopausal women with specific risk factors for coronary artery disease.
        Maturitas. 1998; 30: 27-36
        • Pines A.
        • Averbuch M.
        • Fisman E.Z.
        • Rosano G.M.
        The acute effects of sublingual 17β-estradiol on the cardiovascular system.
        Maturitas. 1999; 33: 81-85
        • Signorelli S.S.
        • Sciacchitano S.
        • Costa M.P.
        • Di Pino L.
        • Pennnisi G.
        • Caschetto S.
        Behaviour of the carotid wall in menopausal women with and without arterial hypertension.
        Maturitas. 2000; 35: 39-43
        • Fisman E.Z.
        • Tenenbaum A.
        • Shapira I.
        • Motro M.
        • Pines A.
        The acute effects of sublingual estradiol on left ventricular diastolic function in normotensive and hypertensive postmenopausal women.
        Maturitas. 1999; 33: 145-152
        • Griewing B.
        • Romer T.
        • Spitzer C.
        • Ludemann J.
        • Gunther A.
        • Kessler C.
        Hormone replacement therapy in postmenopausal women: carotid intima-media thickness and 3-D volumetric plaque quantification.
        Maturitas. 1999; 32: 33-40
        • Stampfer M.J.
        • Hu F.B.
        • Manson J.E.
        • Rimm E.B.
        • Willett W.C.
        Primary prevention of coronary heart disease in women through diet and lifestyle.
        N. Engl. J. Med. 2000; 343: 16-22