OJOG  Vol.4 No.14 , October 2014
The Role of Premenstrual Syndrome in the Causation of Arterial Hypertension in Women
Abstract: Introduction: Gender perspectives are gradually generating great interest in health matters. Hypertension is one illness where gender considerations are important. Advancements in knowledge of pathophysiology help in better understanding of diseases and improvements in treatment. Pre-menstrual syndrome has been reported to make hypertension less responsive to treatment. This work was therefore done to see if premenstrual syndrome contributed in some way to hypertension in women. Methodology: All female hypertensives consulting the author in a private specialized hypertension clinic were questioned using the University of Carlifornia at San Diego criteria with a view to determining if they suffered from pre-menstrual syndrome. The control status was also considered for each patient. Females who consulted over the same period and were not hypertensive served as controls. Result: Pre-menstrual syndrome was found to occur more in hypertensive women than normotensive controls; to a statistically significant extent (p < 0.05). Control tended to be poorer in hypertensives with pre-menstrual syndrome than those without. The difference however did not achieve statistical significance. Discussion: There is controversy surrounding the aetiology of pre-menstrual syndrome. However, each of the models albeit inconsistent is capable of initiating and sustaining hypertension. The result here shows that in women it is likely to be one of the many factors that could produce hypertension in those predisposed. Conclusion: Pre-menstrual syndrome should arouse suspicion of future hypertension, and should be sought in all female hypertensives. Its presence should evoke deliberate action to improve outcome or remove the need for pharmacotherapy, at least for some time.
Cite this paper: Okeahialam, B. (2014) The Role of Premenstrual Syndrome in the Causation of Arterial Hypertension in Women. Open Journal of Obstetrics and Gynecology, 4, 817-821. doi: 10.4236/ojog.2014.414113.

[1]   Legato, M.J. (2003) Beyond Women’s Health: The New Discipline of Gender Specific Medicine. Medical Clinics of North America, 5, 917-937.

[2]   Hanes, D.S., Weir, M.R. and Sowers, J.R. (1996) Gender Considerations in Hypertension Pathophysiology and Treatment. The American Journal of Medicine, 101, 10S-21S.

[3]   Kaplan, N.M. (2004) What Can We Expect from New Guidelines? Medical Clinics of North America, 88, 141-148.

[4]   Savoia, C. and Schiffrin, E.L. (2004) Significance of Recently Identified Peptides in Hypertension: Endothelin, Natriuretic Peptides, Adrenomedulin, Leptin. Medical Clinics of North America, 88, 39-62.

[5]   Johnson, S.R. (1987) Pre-Menstrual Syndrome (Foreword). Clinical Obstetrics and Gynecology, 30, 365-366.

[6]   Johnson, S.R. (1987) The Epidemiology and Social Impact of Pre-Menstrual Syndrome. Clinical Obstetrics and Gynecology, 30, 367-376.

[7]   Okeahialam, B.N. (2004) Refractory Hypertension Controlled after Identifying and Addressing Pre-Menstrual Syndrome. Journal of the National Medical Association, 96, 1422-1423.

[8]   Dickerson, R.M., Mazyck, P.J. and Hunter, M.H. (2003) Pre-Menstrual Syndrome. American Family Physician, 67, 1743-1752.

[9]   Rasheed, P. and Al-Sowielem, L.S. (2003) Prevalence and Predictors of Pre-Menstrual Syndrome among College Aged Women in Saudi Arabia. Annals of Saudi Medicine, 23, 381-387.

[10]   Daugherty, J.E. (1998) Treatment Strategies for Pre-Menstrual Syndrome. American Family Physician, 58, 183-192, 197-198.

[11]   Steiner, M. and Born, L. (2000) Diagnosis and Treatment of Premenstrual Dysphoric Disorder. An Update. International Clinical Psychopharmacology, 15, S5-S17.

[12]   Okeahialam, B.N., Obindo, J.T. and Ogbonna, C. (2008) Prevalence of Premenstrual Syndrome and Its Relationship with Blood Pressure in Young Adult Females. African Journal of Medicine Medical Sciences, 37, 361-367.

[13]   Kaplan, N.M. (1994) Primary Hypertension. Pathogenesis. In: Kaplan, N.M., Ed., Clinical Hypertension, Wilkins and Wilkins, Baltimore/Philadelphia/Hongkong/London/Munich/Sydney/Tokyo, 47-108.

[14]   Hallman, J. (1986) The Premenstrual Syndrome—An Equivalent of Depression? Acta Psychiatrica Scandinavica, 73, 403-411.

[15]   Saeed, A.K. and Al-Dabbagh, T.Q. (2003) Type 2 Diabetes and Its Association with Hypertension and Depression in an Iraqi Population. Annals of Saudi Medicine, 23, 254-259.

[16]   Carpenter, P.C. (1988) Diagnostic Evaluation of Cushings Syndrome. Endocrinology Metabolism Clinics of North America, 17, 445-472.

[17]   Jonas, B.S., Fraubs, P. and Ingram, D.D. (1997) Are Symptoms of Anxiety and Depression Risk Factors for Hypertension? Longitudinal Evidence from the National Health and Nutritional Diseases/Epidemiological Follow-Up Study. Archives of Family Medicine, 6, 43-49.

[18]   Shechter, A. and Boivin, D.B. (2010) Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women with Premenstrual Dysphoric Disorder. International Journal of Endocrinology, 2010, Article ID: 259345.

[19]   Baker, F.C., Kahan, T.L., Trinder, J. and Colrain, I.M. (2007) Sleep Quality and the Sleep Electroencephalogram in Women with Severe Premenstrual Syndrome. Sleep, 30, 1283-1291.

[20]   Meelo, P., Sgoifo, A. and Suchecki, D. (2008) Restricted and Disrupted Sleep: Effects on Autonomic Function, Neuroendocrine Stress Systems and Stress Responsivity. Sleep Medicine Reviews, 12, 197-210.

[21]   Stickler, R.C. (1987) Endocrine Hypothesis for the Etiology of Premenstrual Syndrome. Clinical Obstetrics & Gynecology, 30, 377-385.

[22]   Reid, R.L. (1988) Etiology: Medial Models. In: Keye Jr., W.R., Ed., The Pre-Menstrual Syndrome, WB Saunders Co., Philadelphia/Toronto/Montreal/Sydney/Tokyo, 75-77.

[23]   Sharma, B.K., Sharma, N. and Jain, S. (1999) Hypertension and the Kidneys: Inter-Relationship and Therapeutic Approach. Journal of Indian Medical Association, 97, 91-105.

[24]   Muntner, P., Shimbo, D., Tonelli, M., Reynolds, K., Arnett, D.K. and Oparil, S. (2011) The Relationship between Visit-to-Visit Variability in Systolic Blood Pressure and All-Cause Mortality in the General Population: Findings from NHANES III, 1988-1994. Hypertension, 57, 160-166.

[25]   Stamatelopoulos, K.S., Georgiopoulos, G., Papaioannou, T., Lambrinoudaki, I., Kouzoupis, A., Vlachopoulos, C., et al. (2012) Can Premenstrual Syndrome Affect Arterial Stiffness or Blood Pressure? Atherosclerosis, 224, 170-176.

[26]   Frohlich, E.D. (2004) Innovative Concepts of Hypertension to Understand and Manage the Disease (Preface). Medical Clinics of North America, 88, 13-21.