Effects of blood pressure reduction on cardiovascular risk estimates in hypertensive postmenopausal women

Menopause is accompanied by an increased prevalence of hypertension, which may partially explain the corresponding cardiovascular risk observed in postmenopausal women. The relationship between blood pressure and cardiovascular risk is continuous, consistent and independent of other risk factors. There are profound benefits of treating hypertension: antihypertensive therapy has been associated with large reductions in stroke, myocardial infarction and heart failure. Despite these proven benefits, hypertension is inadequately treated, or not treated at all, in the majority of patients. There has been concern regarding the use of hormone therapy in hypertensive postmenopausal women. Drospirenone/17beta-estradiol, a hormone therapy, has been demonstrated to lower blood pressure in hypertensive postmenopausal women either alone or when administered simultaneously with antihypertensive drugs. This might offer a potential advantage in patients with elevated blood pressure. It is also known that the risk for target organ events extends to levels well below the established definition of 140/90 mmHg. High-normal blood pressure carries an increased cardiovascular risk when compared to lower levels of blood pressure. Identification and management of elevated blood pressure are an important component of the successful management of the postmenopausal woman and can help prevent the untoward consequences of elevated blood pressure.