Blood pressure patterns in adolescents with premenstrual syndrome: office, home, and ambulatory blood pressure monitoring across the menstrual cycle

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Premenstrual syndrome (n=52). Intervention: Premenstrual syndrome vs. Adolescents without premenstrual syndrome. Primary outcome: Morning systolic blood pressure via 7-day home blood pressure monitoring in the luteal versus follicular phase within the premenstrual syndrome group (p=0.001).

Q: What does this research mean for the field?

Adolescents with premenstrual syndrome exhibit significantly higher morning and mean systolic blood pressure during the luteal phase compared with the follicular phase, despite showing overall blood pressure levels comparable to peers without premenstrual syndrome. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Özlem Akbulut; Sinem Akgül; Melis Pehlivantürk Kızılkan; Laden Jaferi; Erdem Karabulut; Nuray Kanbur; Orhan Derman; Ali Düzova

doi:10.1007/s00467-026-07517-x

August 18, 2026Pediatric NephrologyOpen Access

Blood pressure patterns in adolescents with premenstrual syndrome: office, home, and ambulatory blood pressure monitoring across the menstrual cycle

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Key result

Premenstrual syndrome in adolescents is linked to higher luteal-phase morning systolic blood pressure.

P=0.001
n=52

Why the study?

Premenstrual syndrome has been associated with renin–angiotensin–aldosterone system dysregulation, a pathway implicated in hypertension, but blood pressure patterns in adolescents with PMS across the menstrual cycle remain unclear.

Does premenstrual syndrome alter blood pressure patterns across the menstrual cycle in female adolescents?

Key Points

To evaluate blood pressure patterns across follicular and luteal menstrual cycle phases in adolescents with and without premenstrual syndrome using office, home, and ambulatory monitoring.
Enrolled 31 adolescents with premenstrual syndrome (mean age 15.61 ± 1.42 years) and 21 controls without it (mean age 14.82 ± 1.40 years).
Evaluated hemodynamic parameters using office blood pressure, 7-day home blood pressure monitoring, and 24-hour ambulatory blood pressure monitoring during the follicular and luteal phases.
Analyzed 52 follicular phase and 33 luteal phase evaluations after excluding sessions due to missed visits or luteal progesterone levels below 3.5 ng/ml.
Office, home, and ambulatory blood pressure values showed no statistically significant differences between adolescents with and without premenstrual syndrome in either phase.
Within the premenstrual syndrome group, 7-day home monitoring showed significantly higher morning (p = 0.001) and mean systolic blood pressure (p = 0.006) during the luteal phase compared to the follicular phase.
Ambulatory monitoring in the premenstrual syndrome group demonstrated lower 24-hour diastolic blood pressure (p = 0.029), lower daytime diastolic blood pressure (p = 0.019), and higher pulse pressure (p = 0.018) in the luteal phase.

Study Design

Type

Observational (n=52)

Multicenter

No

Structured PICO

Does premenstrual syndrome alter blood pressure patterns across the menstrual cycle in female adolescents?

P

Population

52 female adolescents aged 12 to 18 years, including 31 with premenstrual syndrome, evaluated for blood pressure variations across the menstrual cycle.

E

Exposure

Blood pressure evaluation (office BP, 7-day home BP monitoring, and 24-hour ambulatory BP monitoring) during the luteal phase of the menstrual cycle.

C

Comparator

Blood pressure evaluation during the follicular phase of the menstrual cycle (intra-individual comparison), and comparison against the cohort of adolescents without PMS.

O

Outcome

Blood pressure patterns (systolic BP, diastolic BP, mean arterial pressure, pulse pressure) across the menstrual cycle measured via office BP, 7-day home BP monitoring, and 24-hour ambulatory BP monitoring.surrogate

Main Result

p-value: p=0.001

Adolescents with premenstrual syndrome exhibit phase-specific hemodynamic alterations, notably increased luteal-phase systolic blood pressure and pulse pressure, which may represent an early marker of cardiovascular risk.

Limitations

Small sample size, impacted by the challenges of repeated measurements, protocol adherence, and the pandemic
Participant attrition due to missed luteal phase follow-ups and progesterone levels below the predefined threshold
Ambulatory blood pressure monitoring coincided with the mid-luteal phase, potentially failing to capture peak premenstrual syndrome symptom changes in the late-luteal phase
Lack of evaluation for depression and anxiety, which are common psychiatric comorbidities that could influence autonomic dysregulation and cardiovascular risk
small sample size
impacted by the challenges of repeated measurements, adherence to protocols, and the pandemic
ABPM assessment coincided with the mid luteal phase, which may not have captured changes as adequately as the late luteal phase
depression and anxiety were not evaluated

Implication

Luteal-phase systolic BP rises in adolescents with PMS may signal early vulnerability; extends adult data but leaves open prospective validation before monitoring changes.

Abstract

Background: Premenstrual syndrome (PMS) has been associated with dysregulation of the renin–angiotensin–aldosterone system (RAAS), a pathway also implicated in hypertension. Evaluation of blood pressure (BP) patterns in adolescents with PMS may therefore clarify shared neu...

Discussion

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Cite This Study

Akbulut et al. (2026) conducted an observational in Premenstrual syndrome (n=52). Premenstrual syndrome vs. Adolescents without premenstrual syndrome was evaluated on Morning systolic blood pressure via 7-day home blood pressure monitoring in the luteal versus follicular phase within the premenstrual syndrome group (p=0.001). Adolescents with premenstrual syndrome demonstrated significantly higher morning and mean systolic blood pressure during the luteal phase compared to the follicular phase (p=0.001), despite no overall differences when compared to peers without premenstrual syndrome.

synapsesocial.com/papers/6ad115a300741cc3fba7d6f5 https://doi.org/10.1007/s00467-026-07517-x

View Full Paper

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Blood pressure patterns in adolescents with premenstrual syndrome: office, home, and ambulatory blood pressure monitoring across the menstrual cycle

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Blood pressure patterns in adolescents with premenstrual syndrome: office, home, and ambulatory blood pressure monitoring across the menstrual cycle

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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