Correlation between Blunted Nocturnal Blood Pressure Decline and Sex Hormone Imbalance in Hypertensive Women with Different Menopausal Durations: A Cross-Sectional Study

Correlation between Blunted Nocturnal Blood Pressure Decline and Sex Hormone Imbalance in Hypertensive Women with Different Menopausal Durations: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Correlation between Blunted Nocturnal Blood Pressure Decline and Sex Hormone Imbalance in Hypertensive Women with Different Menopausal Durations: A Cross-Sectional Study Sijie Zhang, Heng Yu, Chenyang Jing, Wei Liang, Lei Chen, Yurui Lin, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7760424/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 Jan, 2026 Read the published version in European Journal of Medical Research → Version 1 posted 13 You are reading this latest preprint version Abstract Background The prevalence of hypertension in postmenopausal women increases significantly compared to premenopausal women and gradually catches up with, or even surpasses, that of their male counterparts. Imbalanced levels of sex hormones play a critical role in the elevation of blood pressure (BP) observed in this population. Furthermore, blunted nocturnal BP decline is a key factor contributing to their increased cardiovascular risk. This study compared ambulatory blood pressure (ABP) indices between female hypertensive patients with different menopausal durations and matched male patients, aiming to explore the correlation between varying degrees of sex hormone environment disturbance and ABP indices. Methods This cross-sectional study included 210 postmenopausal women and 210 matched male patients. Clinical characteristics, Ambulatory Blood Pressure Monitoring (ABPM), and sex hormone levels were evaluated. Quantitative data were analyzed using one-way analysis of variance and multiple regression analysis. Results Compared with matched men, in women with hypertension within 5 years after menopause, the T/PRL–E₂ served as an independent risk factor for blunted nocturnal systolic blood pressure (SBP) decline. In those with menopausal durations of 6–10 years, the FSH/T ratio is a risk factor contributing to the absence of significant differences in 24-h SBP and daytime SBP relative to matched men, while the PRL/FSH ratio exerted a negative effect on nighttime SBP in this group. In hypertensive women with menopausal durations of 11–15 years, the PRL-E 2 /T ratio is a risk factor for 24-h and daytime SBPs, as well as for blunted nocturnal SBP decline. In contrast, correlations involving diastolic blood pressure (DBP) indices displayed a distinct pattern. The FSH/PRL ratio exhibited protective effects on all mean DBP parameters in hypertensive women with menopausal durations less than 5 years and 11–15 years, whereas the T/P ratio showed a protective role in those with 6–10 years of menopause. Conclusions There was a significant correlation between sex hormone levels and ABP parameters, particularly nocturnal SBP, in women with different menopausal durations. Trial registration This study was retrospectively registered on ClinicalTrials.gov (NCT03451747) on February 18, 2018. Postmenopause Menopausal Duration Hypertension Sex Hormone Nocturnal Blood Pressure Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 19 Jan, 2026 Read the published version in European Journal of Medical Research → Version 1 posted Editorial decision: Revision requested 20 Nov, 2025 Reviews received at journal 13 Nov, 2025 Reviews received at journal 07 Nov, 2025 Reviews received at journal 03 Nov, 2025 Reviewers agreed at journal 03 Nov, 2025 Reviewers agreed at journal 31 Oct, 2025 Reviewers agreed at journal 20 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers agreed at journal 12 Oct, 2025 Reviewers invited by journal 12 Oct, 2025 Editor assigned by journal 07 Oct, 2025 Submission checks completed at journal 07 Oct, 2025 First submitted to journal 01 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7760424","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":533176215,"identity":"a8041f82-2359-43e4-ae56-145fdc3d5182","order_by":0,"name":"Sijie Zhang","email":"","orcid":"","institution":"Lanzhou University Second Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sijie","middleName":"","lastName":"Zhang","suffix":""},{"id":533176216,"identity":"2a4109ee-9c06-4066-95f4-ecf6972a24a4","order_by":1,"name":"Heng Yu","email":"","orcid":"","institution":"Lanzhou University Second 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Decline and Sex Hormone Imbalance in Hypertensive Women with Different Menopausal Durations: A Cross-Sectional Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Postmenopause, Menopausal Duration, Hypertension, Sex Hormone, Nocturnal Blood Pressure","lastPublishedDoi":"10.21203/rs.3.rs-7760424/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7760424/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe prevalence of hypertension in postmenopausal women increases significantly compared to premenopausal women and gradually catches up with, or even surpasses, that of their male counterparts. Imbalanced levels of sex hormones play a critical role in the elevation of blood pressure (BP) observed in this population. Furthermore, blunted nocturnal BP decline is a key factor contributing to their increased cardiovascular risk. This study compared ambulatory blood pressure (ABP) indices between female hypertensive patients with different menopausal durations and matched male patients, aiming to explore the correlation between varying degrees of sex hormone environment disturbance and ABP indices.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis cross-sectional study included 210 postmenopausal women and 210 matched male patients. Clinical characteristics, Ambulatory Blood Pressure Monitoring (ABPM), and sex hormone levels were evaluated. Quantitative data were analyzed using one-way analysis of variance and multiple regression analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eCompared with matched men, in women with hypertension within 5 years after menopause, the T/PRL\u0026ndash;E₂ served as an independent risk factor for blunted nocturnal systolic blood pressure (SBP) decline. In those with menopausal durations of 6\u0026ndash;10 years, the FSH/T ratio is a risk factor contributing to the absence of significant differences in 24-h SBP and daytime SBP relative to matched men, while the PRL/FSH ratio exerted a negative effect on nighttime SBP in this group. In hypertensive women with menopausal durations of 11\u0026ndash;15 years, the PRL-E\u003csub\u003e2\u003c/sub\u003e/T ratio is a risk factor for 24-h and daytime SBPs, as well as for blunted nocturnal SBP decline. In contrast, correlations involving diastolic blood pressure (DBP) indices displayed a distinct pattern. The FSH/PRL ratio exhibited protective effects on all mean DBP parameters in hypertensive women with menopausal durations less than 5 years and 11\u0026ndash;15 years, whereas the T/P ratio showed a protective role in those with 6\u0026ndash;10 years of menopause.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThere was a significant correlation between sex hormone levels and ABP parameters, particularly nocturnal SBP, in women with different menopausal durations.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e\u003cp\u003eThis study was retrospectively registered on ClinicalTrials.gov (NCT03451747) on February 18, 2018.\u003c/p\u003e","manuscriptTitle":"Correlation between Blunted Nocturnal Blood Pressure Decline and Sex Hormone Imbalance in Hypertensive Women with Different Menopausal Durations: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-25 09:10:07","doi":"10.21203/rs.3.rs-7760424/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-21T02:56:34+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-13T21:49:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-08T03:21:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-03T17:24:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331876372859281775413600182191913934786","date":"2025-11-03T08:57:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"169779407959327256743780074702759539567","date":"2025-10-31T12:14:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"225129732036760302710024209512470301166","date":"2025-10-21T00:36:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68063525411141677373870717328408007638","date":"2025-10-14T22:13:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"287784024683883235012606648098547072870","date":"2025-10-12T08:14:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-12T06:40:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-07T17:19:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-07T08:15:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Medical Research","date":"2025-10-01T14:27:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"89680a32-f2f2-4a4e-9f97-4ee3c294bc52","owner":[],"postedDate":"October 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-26T16:04:47+00:00","versionOfRecord":{"articleIdentity":"rs-7760424","link":"https://doi.org/10.1186/s40001-025-03797-5","journal":{"identity":"european-journal-of-medical-research","isVorOnly":false,"title":"European Journal of Medical Research"},"publishedOn":"2026-01-19 15:58:17","publishedOnDateReadable":"January 19th, 2026"},"versionCreatedAt":"2025-10-25 09:10:07","video":"","vorDoi":"10.1186/s40001-025-03797-5","vorDoiUrl":"https://doi.org/10.1186/s40001-025-03797-5","workflowStages":[]},"version":"v1","identity":"rs-7760424","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7760424","identity":"rs-7760424","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}