Vol.5 No.

1 2022

MENOPAUSE ASSOCIATED HYPERTENSION AND ITS RELATION TO

ANTHROPOMETRIC PARAMETERS IN WOMEN OF NAWABSHAH
(SBA) SINDH

Nosheen Aghani1, Ghulam Qadir1, Imam Bux/Ayaz1, Amjad Ali1, Mehak Memon1,
Mehwish Memon2

1. Peoples University of Medical and Health Sciences for Women SBA.

2. Bakhtawar Amin Medical and Dental College Multan

Corresponding author:
Dr Nosheen Aghani
Assistant Professor Biochemistry department PUMHSW SBA
Email: [email protected]
Dr Ghulam Qadir
Assitant director PUMHSW SBA
Dr Imam Bux/ Ayaz
Senior medical officer
Dr Amjad Ali
Senior lecturer Biochemistry department PUMHSW
Dr Mehk Memon
Assistant professor Biochemistry department PUMHSW
Dr Mehwish Memon
Assistant professor Bakhtawar Ameen medical college Multan

ABSTRACT:
High blood pressure had recognized as a most important reason of morbidity and mortality in mutually advanced
and undeveloped countries. The females at postmenopause remain on high risk of cardiovascular problems globally,
and this problem increases by the ageing. 600 contestants existed in our research were separated into 3
groups. Participants were enlisted according to the conditions of designed proforma. All participants
provided stated and written contract after being informed about the study's purpose. Anthropometric
parameters of all the participants were taken. The descriptive statistics presented as mean and standard
deviation through using the ANOVA test. The mean values of weight, waist circumference, hip
circumference, waist hip ratio, systolic blood pressure and diastolic blood pressure were raised in
postmenopausal females in comparison to premenopausal and normal healthy females with significant
difference of (p<0.001). The mean values of BMI and mid upper arm circumference (MUAC) of
postmenopausal participants were slightly raised in comparison with control group and premenopausal
participants (p<0.05). We determined in this research that females later menopause were at greater
probability of high blood pressure and other related diseases. The existing study is intellectualized to observe
numerous bio-social prognosticators of blood pressure rise and their likely influence toward increased blood
pressure in females.
Key words: Hypertension, premenopause, postmenopause
INTRODUCTION:
In both industrialized and underdeveloped countries, rise in blood pressure had recognized as a
leading reason of morbidity and mortality.1 The bulk of cardiovascular disease (CVD) in the
globe is caused solely by hypertension. The over-all problem of hypertension, a possibility
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reason of many degenerative diseases, is significant.2 Diabetes, insulin resistance, and

cardiovascular disease (CVD) are a few of the chronic non-communicable diseases (NCDs) that
have been identified to be specifically associated with obesity. In prior investigations, obesity
and hypertension were linked to negative health effects. Obesity and hypertension are linked to a
number of health problems, making it harder to provide effective primary care in the twenty-first
century.3 Over 25% of adult females worldwide have high blood pressure. Globally,
postmenopausal women are more likely to experience cardiovascular issues, and their risk rises
with age.4 The prevalence of increased blood pressure, stress, dyslipidemia, obesity, diabetes
mellitus, decreased glucose tolerance, vascular inflammation, fluctuations in the pattern of fat
distribution, and other conditions have all been linked to such risks. Due to the reduction of
estrogen synthesis after menopause, blood pressure rises, which contributes the greater
occurrence of rise in blood pressure in aged females.5 The first ten years following menopause
are characterized by the rise in blood pressure. Women were more likely than males to have
hypertension during their seventh decade of life. Cardiovascular problems caused by
hypertension were more common in females at the time of menopause than men with same age,
and these complications were identified as the major reason for death in females.6,7 Credentials
of potential possibility factors and postmenopausal women's prevention of hypertension are
crucial given the ageing of the global population.8 Blood pressure elevations in women have
been related to the greater possibility of CVD, and hypertension is more common in women over
60.9 Adult CVD has been on the rise in recent decades, and this tendency may continue. To
prevent an increase in the burden of hypertension and associated CVDs among women, it is
important to pay attention to the relationship between hypertension and the menopause and
associated risk factors. It is becoming more and more crucial to have knowledge about high
blood pressure and its causes in order to improve current medical services.10
MATERIAL AND METHODS:

This study was done at the Department of Biochemistry Peoples University of Medical
Health Sciences for Women Nawabshah Shaheed Benazirabad (PUMHSW) along the
cooperation with Gynecology and Obstetrics and Medicine OPD/Ward PMCH. The
analysis of sample had been done at diagnostic and research laboratory PUMHSW,
Shaheed Benazirabad (SBA).

STUDY DESIGN: Comparative cross sectional.

SAMPLE TECHNIQUE: Non probability convenience random sample selection.

INCLUSION CRITERIA:
 Normal healthy women between ages of 20 to 35 years.
 Premenopausal and postmenopausal women between ages among 40 years to 60 years.
 Premenopausal and postmenopausal females with hypertension.

EXCLUSION CRITERIA:
 All the females below 20 years and above age 60 years.
 Patients with existing endocrinal disorders, renal disorder, liver disorder, cardiac disease,
hysterectomy and oophorectomy.

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 Those who are on treatment.

SAMPLE SIZE:
Sample size had been designed by means of the Rao software with prevalence of 15.74%
premenopausal women and 59.06% postmenopausal women by means of the perc entage in
95% of confidential intervals then 5% of margins of errors, the sample size of
premenopause stood to be n=204 and postmenopause n=372. Where n1+n2=576. Total 600
participants had been included in present study, divided in to group A, B and C.

GROUP A: Comprises of 200 normal healthy women as control group between age group
of 20 to 35 years.

GROUP B: Comprises of 200 premenopausal hypertensive women between age group of

36 years to 50 years.

GROUP C: Comprises of 200 postmenopausal hypertensive women between age group of

50 years to 60 years.

Subjects were recruited according to the criteria of designed proforma from Department of
Obstetrics and Gynecology and Medicine OPDs PMCH Nawabshah. For this study, We
collected complete medical data and pertinent information from every women through
filling out a proforma. All participants gave verbal and written agreement after being
informed about the study's purpose.

ANTHROPOMETRIC PARAMETERS:

Neck, waist circumference, and hip ratio were restrained by means of a bendable but non -
stretchable plastic calculating tape. The height was measured on a scale in centimeters
(CM), while the weight was measured on a weighing machine. The circumference wa s
measured transient the superior margins of the seventh cervical vertebrae then the inferior
margins of the laryngeal prominence that remain on the contracted neck levels, to the
nearest 1 mm. The WHO recommends a neck circumference of 34 cm for females. In a
horizontal plane, the waist circumference (WC) stayed restrained midway among the
inferior border of the ribs and the iliac crest. The hip circumference (HC) was measured
over the greater trochanters at its broadest point. A formula was used to comput e the waist
to hip ratio (WHR).According to the WHO, a typical waist circumference for women is 80
cm, a normal hip circumference is 94.35 cm, and a normal WHR is 0.85 cm.

ETHICAL CONSIDERATION: This study had been accompanied firmly upon the ethical
instructions later the agreement from Ethical Review Committee of PUMHSW Nawabshah.
STATISTICAL ANALYSIS PROCEDURE
For the data analyzes SPSS Version 22.0 was used. ANOVA test applied for comparison among
the study groups. Results were shown as mean and standard deviation.
RESULTS: The means± standard deviations (SD) of age, weight, BMI, height, neck
circumference, waist circumference, hip circumference, waist/hip ratio, systolic BP, diastolic BP,

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and mid upper arm circumference (MUAC) of study participants were noted in Table-4.2. The
mean ±SD of age of the group A was 28.60±4.97 years as matched to the group B and C was
44.44±2.61 and 54.78±2.80 years with the significant p-value <0.001.
The mean value of weight of control group was 53.75±10.6 Kg as matched to Group B and C
was noted as 62.16±11.2 Kg and 64.6±11.6 Kg respectively with the significant difference of
(p<0.001). Then mean values of height of normal healthy females was noted as 5.10±.11 Cm as
compared to the Group B and C participants was 5.11±.16 Cm 5.08±.16 Cm whereas presenting
the difference of insignificant p value (p=0.057). The mean value of Body mass index (BMI) of
control group was noted as 21.1±4.2 Kg/m2 as matched to the Group B and C was noted as
24.32±5.13 Kg/m2 and 26.0±5.6 Kg/m2where as presenting the difference of significant p value
(p<0.05). The mean and SD of neck circumference (NC) of Control group was noted as 34.3±1.9
Cm as compared to Pre and Postmenopausal females was 35.8±2.1 Cm and 35.7±2.5 Cm
respectively with insignificant (p<0.58)., The mean and SD of waist circumference (WC) of
normal healthy females was 65.5±3.9 Cm as compared to Group B and C was noted as 72.8±2.3
Cm and 73.1±2.2 Cm with very high significant (p<0.001).The mean and SD of hip
circumference (HP) of control group was 97.6±5.71 Cm as compared to pre and postmenopausal
females was 101.6±5.3 Cm and 103.2±3.54 Cm respectively with significant (p<0.001).The
mean value of waist/hip ratio of normal Healthy females was 0.49±0.05 in comparison with the
Group B and C participants was 0.55±0.03 and 0.56±0.03 correspondingly with significant p
value of (p<0.001). The mean and SD of systolic and diastolic BP of pre and postmenopausal
participants was raised as compared to the normal Healthy females. The mean value of systolic
BP of control group was noted as 122.2±10.7 mmHg as compared to the group B and C
participants was 134.8±16.3 mmHg and 139.0±15.4 mmHg. The mean value of diastolic BP of
normal healthy females was 81.2±9.3 mmHg as compared to the premenopausal and
postmenopausal women was 90.2±11.8 mmHg and 92.6±10.4 mmHg respectively. The mean
values of systolic BP and diastolic BP of study participants showing the very high significance of
(p<0.001).The mean and SD of MUAC of control group was noted as 25.51±1.65 as compared
to the Group B and C participants was 27.22±2.11 and 27.40±2.32 respectively with
significant(p<0.05).

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Table # 1
Anthropometric Constraints of Pre and Postmenopausal Females as matched with
Normal Healthy Females

Controls Cases Cases

Variables Group-A Group-B Group-C p-value
Normal Healthy Premenopause Postmenopause
women females females
(n=200) (n=200) (n=200)
Age
(Years) 28.60±4.976 44.44±2.612 54.78±2.809 <0.001

Weight
(Kg) 53.75±10.6 62.16±11.2 64.6±11.6 <0.001

Height
(Cm) 5.10±.112 5.11±.16 5.08±.16 0.057 NS

BMI
(Kg/m2) 21.1±4.23 24.32±5.13 26.0±5.6 <0.05

Neck
Circumference 34.3±1.9 35.8±2.1 35.7±2.5 <0.058 NS
(Cm)
Waist
circumference 65.5±3.9 73.8±2.3 73.5±3.52 <0.001
(Cm)
Hip
circumference 97.6±5.71 101.6±5.3 103.2±3.54 <0.001
(Cm)

Waist/Hip ratio 0.49±0.05 0.55±0.03 0.56±0.03 <0.001

Systolic Blood
Pressure 120.2±5.7 168.8±26.3 189.5±25.45 <0.001
(mmHg)

Diastolic
Blood pressure 81.2±9.3 94.2±11.8 95.6±10.4 <0.001
(mmHg)

MUAC 29.51±3.61 27.2±2.1 26.40±2.3 <0.05

  
p<0.05, p<0.01, p<0.001 and NS= Not significant

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DISCUSSION:
In existing study the mean and SD of age of group A, B and C was 28.6±4.97, 44.44±2.61
and 54.78±2.8 years and it is comparable with Sarukasasula A et al study.
Several studies revealed that the anthropometric measurements were altered due to
transition of normal healthy females towards menopausal state in their life span. Park KM
et al stated that postmenopausal women were overweight as compared to the
premenopausal women, similar findings were observed in this study.
Warsi J et al observed the insignificant difference of height in their study participants, the
similar findings were observed by present study, the height of the study participants shown
insignificant difference. There are more than half a billion adults who are overweight or
obese, according to WHO epidemiological figures. According to Shobeiri et al and
Ghorbani et al, postmenopausal women had a higher BMI than premenopausal women. In
current study weight and BMI of postmenopausal females was greater than the
premenopause and control group with substantial difference of (p<0.001). Fat deposition
around the neck is a distinct feature of upper body subcutaneous adipose tissue. The neck
circumference (NC) has been established as a surrogate metric for evaluating the
distribution of upper body subcutaneous fat. It is a low-cost, dependable, noninvasive,
repeatable method that is unaffected by respiratory or stomach fullness phases. Previous
studies estimated that NC is the biomarker of obesity but present study has shown no any
statistically significant difference of NC between the study participants. Some researchers
believe that a lack of estrogens is a significant obesity-causing factor. Anthropometric
parameters like weight, BMI, waist circumference (WC), hip circumference (HP) and
waist-hip ratio (WHR) are considered for obesity evaluation. Fat mass in menopausal
women increases and it will change from gynacoid form to android form. Deibert P et al
estimated that WC, HC and WHR of the postmenopausal women was greater than the
premenopausal women which was consistent with the present study. The current study's
postmenopausal ladies had higher systolic and diastolic blood pressure than the
premenopausal and control groups. The present study's systolic and diastolic blood
pressure results were equivalent to those of Zanchetti A et al.
CONCLUSION:
We concluded in this study that women after menopause were at high possibility of
hypertension and other comorbidities. The present study is conceptualized to examine various
bio-social predictors of hypertension and their possible contribution toward hypertension among
women.
Conflict of interest: The study has no conflict of interest to declare by any author.
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