Association of free androgen index and sex hormone–binding globulin and left ventricular hypertrophy in postmenopausal hypertensive women

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2021-07, Vol.23 (7), p.1413-1419
• Main Authors: Jianshu, Chen, Qiongying, Wang, Ying, Pei, Ningyin, Li, junchen, Han, Jing, Yu
• Format: Article
• Language: English
• Subjects: Androgens; Antihypertensives; Blood pressure; Body mass index; Diuretics; Enzymes; Female; free androgen index; Hormone replacement therapy; Humans; Hypertension; Hypertension - epidemiology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - epidemiology; Kinases; left ventricular hypertrophy; Menopause; Original; Patients; postmenopausal hypertension; Postmenopause; Serology; Sex Hormone-Binding Globulin; Sex Hormones; Software; Testosterone; Womens health
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.14301

The aim of the present study was to explore the relationship between androgen and LVH in postmenopausal hypertensive women. Enrolled in this study were 378 postmenopausal hypertensive women who were admitted to the department of cardiology between December 2018 and December 2020. According to left ventricular mass index (LVMI) evaluated by echocardiography, the patients were divided into LVH group (n = 172) and non‐LVH group (n = 206). Their clinical characteristics were collected. Based on the result of propensity score matching analysis, 160 cases in each group were matched successfully. After correcting for confounding factors by various models, the results showed that free androgen index (FAI) and sex hormone–binding globulin (SHBG) were the influencing factors of LVH in postmenopausal women with hypertension. Patients with elevated SHBG were 5% less likely to develop LVH than those without elevated SHBG (OR: 0.950, 95% CI 0.922‐1.578). Postmenopausal hypertensive patients with elevated FAI were 16% more likely to have LVH than those without elevated FAI (OR: 1.608, 95% CI 0.807‐3.202). Multiple linear regression showed that LVMI increased by 61.82g/m2 for every 1 unit increase in FAI. In addition, SHBG decreased by 1 nmol/l, and LVMI increased by 0.177g/m2. Subgroup analysis showed that patients in the controlled BP group had a lower risk of LVH for every additional unit of SHBG compared with the uncontrolled BP group. The risk of LVH for each additional unit of FAI in the uncontrolled BP group was higher than that in the controlled BP group. The results of this present study showed that the occurrence of LVH was positively correlated with FAI and negatively correlated with SHBG in postmenopausal women with hypertension. The increase in FAI level and the decrease in SHBG level may be related to the occurrence and development of LVH in postmenopausal hypertension. The prevalence of left ventricular hypertrophy increases dramatically in women after menopause, leading to an increased risk of death from cardiovascular events. Androgen was found to be associated with blood pressure regulation in animal models. However, there has been no clinical study to address the association between androgen and LVH in postmenopausal women.