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Association of blood pressure variability with Endothelin-1 by menopause status among Black women: findings from the Jackson Heart Study

To the Editor:

Postmenopausal women have a higher risk of hypertension compared with premenopausal women possibly related to increased endothelial dysfunction in the setting of lower levels of circulating estrogen. Using data from 660 women in the Jackson Heart Study (JHS), postmenopausal women had higher daytime, nighttime and 24 h systolic blood pressure variability (BPV) compared with premenopausal women, and higher nighttime systolic BPV was associated with higher endothlin-1 (a marker of endothelial dysfunction) in postmenopausal women (ß = 0.27 [0.05, 0.50], p = 0.019), even after adjustment for possible confounders including age. These findings highlight the relevance of menopause status to blood pressure variability and the potential role of blood pressure variability in the development of high endothelin-1 in postmenopausal women.

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Fig. 1: Ambulatory Blood Pressure Monitoring, Endothelin-1 and Menopause Status in the Jackson Heart Study.


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The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I) and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Minority Health and Health Disparities (NIMHD).

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Authors and Affiliations



LR and JC were responsible for all aspects for the study including study concept, study design, data acquisition, data analysis and paper drafting. PM and NB were involved in the study design, data interpretation as well as critical revision of the paper. VP provided critical revision. All authors provided final approval.

Corresponding author

Correspondence to Jordana B. Cohen.

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Competing interests

There are no competing interests for any of the authors. JC is supported by the National Institutes of Health K23-HL133843, R01-HL153646, R01-HL157108, R01-HL155599, R01-HL157264, U01-HL160277, U24-DK060990, and R01-AG074989, and an American Heart Association Bugher Award. The views expressed in this paper are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.

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All participants in the Jackson Heart Study provided informed consent and the University of Mississippi Medical Center, Jackson State University, and Tougaloo College institutional review boards approved the study.

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Rethy, L., Polsinelli, V.B., Muntner, P. et al. Association of blood pressure variability with Endothelin-1 by menopause status among Black women: findings from the Jackson Heart Study. J Hum Hypertens (2023).

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