Could PMS Raise Women's Risk for High Blood Pressure?

Study found rise in odds for hypertension in those with moderate-to-severe premenstrual syndrome

By Robert Preidt

Tuesday, November 24, 2015

TUESDAY, Nov. 24, 2015 (HealthDay News) -- Millions of women suffer through premenstrual syndrome (PMS), and now new research suggests that those with moderate-to-severe PMS may be at heightened risk for high blood pressure later in life.

While the study couldn't prove cause-and-effect, the finding may mean that "women with PMS should be screened for adverse changes in blood pressure and future risk of hypertension," wrote a team led by Elizabeth Bertone-Johnson, an epidemiologist at the University of Massachusetts, Amherst.

The investigators tracked nearly 1,260 women who developed clinically significant PMS between 1991 and 2005, as well as more than 2,400 women with mild PMS. Both groups were followed until 2011.

Women with moderate-to-severe PMS were 40 percent more likely to develop high blood pressure than those with mild or no PMS symptoms, the researchers found.

This higher risk remained after the researchers adjusted for high blood pressure risk factors such as being overweight or obese, smoking, drinking, inactivity, use of birth control pills, postmenopausal hormone use, and family history of high blood pressure.

The link between moderate-to-severe PMS and high blood pressure was strongest among women younger than 40, Bertone-Johnson's group said. In this age group, those with clinically significant PMS were three times more likely to develop high blood pressure.

"To my knowledge, this is the first large long-term study to suggest that PMS may be related to risk of chronic health conditions in later life," Bertone-Johnson said in a university news release.

She and her colleagues did find that moderate-to-severe PMS did not increase the risk of high blood pressure in women with high intakes of the B vitamins thiamine and riboflavin. Recently, the researchers found that women who consumed high levels of those vitamins were 25 to 35 percent less likely to develop PMS.

Clinically significant PMS affects as many as 8 percent to 15 percent of women, the researchers said. However, they believe that it may be possible to reduce the risk of high blood pressure in these women by increasing their intake of B vitamins.

Two experts said the new findings could be important, but questions remain.

"The study is important in identifying an important condition that should lead to closer observation for the onset of high blood pressure," said Dr. Stacey Rosen, vice president of women's health at The Katz Institute for Women's Health in New Hyde Park, N.Y.

She added, however, that "one important limitation is that the average age of these patients was 27 years -- it would be helpful to see if this association persisted in younger women as well."

Dr. Deena Adimoolam is assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. She said that, right now, "many physicians don't consider PMS as a risk factor for hypertension."

And while the study findings are "interesting," she added that "I don't think women should be overly concerned about this association for a few reasons."

First, the study didn't identify and exclude women with conditions that can look like PMS -- chronic fatigue syndrome, anxiety disorders and irritable bowel syndrome, for example -- so, "PMS might have been wrongly diagnosed in some patients," Adimoolam said.

"Also, high blood pressure was self-reported by study participants and not diagnosed by a physician, which makes me question if certain participants truly developed hypertension," she added.

The study was published Nov. 24 in the American Journal of Epidemiology.

SOURCES: Stacey Rosen, M.D., vice president of women's health, The Katz Institute for Women's Health, New Hyde Park, N.Y.; Deena Adimoolam, M.D., assistant professor, medicine, endocrinology, diabetes and bone disease, Icahn School of Medicine at Mount Sinai, New York City; University of Massachusetts, Amherst, news release, Nov. 24, 2015

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