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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Obesity indicators as mediators of the association between age at menopause and blood pressure values

Hypertension Research volume 46, pages 1100–1109 (2023)Cite this article

A Comment to this article was published on 28 February 2023

Abstract

Having a later age at menopause is associated with having a higher blood pressure (BP) value, but the mediation pathways remain unclear. We quantitatively examined the mediation effects of various obesity indicators using baseline data from phase 4 of the Guangzhou Biobank Cohort Study. The product of coefficients approach and bootstrapping procedures were used to assess the mediation effects of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) on the association between age at menopause and BP values. Age, education, occupation, family income, smoking, drinking, diet, physical activity, age at menarche, number of births, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were adjusted as covariates. Of 5429 women with natural menopause, the mean age and menopausal age were 60.0 (standard deviation = 5.8) and 50.3 (3.1) years, respectively. The prevalence of hypertension was 29.6%. In women with a menopausal age of ≥50 years, BMI, WC, WHR and WHtR showed significant mediation effects on the positive association between menopausal age and BP. The adjusted proportion (95% confidence interval) of the mediation effects for those variables were 26.04% (10.40–116.82%), 25.92% (10.19–108.57%), 14.11% (3.59–62.78%), and 23.17% (8.70–95.81%), respectively, for systolic BP values and 22.59% (10.72–53.60%), 20.67% (9.83–49.31%), 9.21% (2.73–23.92%), and 17.19% (7.56–41.31%) for diastolic BP values. In women with a menopausal age of <50 years, no significant association between age at menopause and systolic/diastolic BP values was found. In conclusion, obesity indicators showed significant mediating effects on the association between having a later age at menopause and having a higher BP value. Further longitudinal studies with detailed and accurate measurements of metabolic changes after menopause and sufficient follow-up are warranted to confirm these results.

We demonstrated obesity indicators showed significant mediating effects on the association between later age at menopause (≥50 years) and higher BP.

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Acknowledgements

The Guangzhou Biobank Cohort Study investigators include the Guangzhou Twelfth People’s Hospital: WS Zhang, T Zhu, F Zhu, YL Jin, CQ Jiang (Co-PI); The University of Hong Kong: CM Schooling, SM McGhee, GM Leung, TH Lam (Co-PI); The University of Birmingham: GN Thomas, P Adab, KK Cheng (Co-PI).

Funding

This work was supported by the National Key R&D Program of China (2017YFC0907105) and the Natural Science Foundation of China (81941019). The Guangzhou Biobank Cohort Study was funded by the Guangzhou Twelfth People’s Hospital, The University of Hong Kong Foundation for Educational Development and Research (SN/1f/HKUF-DC; C20400.28505200), the Health Medical Research Fund (Grant number: HMRF/13143241) in Hong Kong; Guangzhou Public Health Bureau (201102A211004011) Natural Science Foundation of Guangdong (2018A030313140), and the University of Birmingham, UK.

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Authors and Affiliations

  1. Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou, 510620, China

    Yong-Jun Wu, Chao-Qiang Jiang, Tong Zhu, Ya-Li Jin, Feng Zhu & Wei-Sen Zhang

  2. School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China

    Bai-Jing Zhou & Lin Xu

  3. Institute of Applied Health Research, University of Birmingham, Birmingham, UK

    Lin Xu

  4. School of Public Health, The University of Hong Kong, Hong Kong, China

    Lin Xu

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Contributions

Y-JW, W-SZ, C-QJ, TZ, Y-LJ, FZ, B-JZ and LX made substantial contributions to the conception and design, acquisition of funding, data analysis and interpretation of data; Y-JW, W-SZ, C-QJ and LX analyzed the data and drafted the article, and W-SZ, C-QJ, LX and B-JZ revised it critically for important intellectual content. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Lin Xu or Wei-Sen Zhang.

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Wu, YJ., Jiang, CQ., Zhu, T. et al. Obesity indicators as mediators of the association between age at menopause and blood pressure values. Hypertens Res 46, 1100–1109 (2023). https://doi.org/10.1038/s41440-023-01184-3

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