A randomized trial on effects of hormone therapy on ambulatory blood pressure and lipoprotein levels in women with coronary artery disease

Pripp, Ulla; Hall, G.; Csemiczky, G.; Eksborg, Staffan; Landgren, Britt-Marie; Schenck‐Gustafsson, Karin

doi:10.1097/00004872-199917100-00004

Cited by 45 publications

(29 citation statements)

References 37 publications

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“…However, in the present study, estrogen therapy did not alter blood pressure, MSNA, blood flow, or vascular resistance. Nevertheless, our results are in accordance with those of other studies (57,60,66,68). The discrepancies might be explained by differences in the type or dose of estrogen administered.…”

Section: Discussionsupporting

confidence: 90%

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Low-dose estrogen therapy does not change postexercise hypotension, sympathetic nerve activity reduction, and vasodilation in healthy postmenopausal women

Oneda

Forjaz²,

Bernardo³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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The aim of this study was to determine whether estrogen therapy enhances postexercise muscle sympathetic nerve activity (MSNA) decrease and vasodilation, resulting in a greater postexercise hypotension. Eighteen postmenopausal women received oral estrogen therapy (ET; n ϭ 9, 1 mg/day) or placebo (n ϭ 9) for 6 mo. They then participated in one 45-min exercise session (cycle ergometer at 50% of oxygen uptake peak) and one 45-min control session (seated rest) in random order. Blood pressure (BP, oscillometry), heart rate (HR), MSNA (microneurography), forearm blood flow (FBF, plethysmography), and forearm vascular resistance (FVR) were measured 60 min later. FVR was calculated. Data were analyzed using a two-way ANOVA. Although postexercise physiological responses were unaltered, HR was significantly lower in the ET group than in the placebo group (59 Ϯ 2 vs. 71 Ϯ 2 beats/min, P Ͻ 0.01). In both groups, exercise produced significant decreases in systolic BP (145 Ϯ 3 vs. 154 Ϯ 3 mmHg, P ϭ 0.01), diastolic BP (71 Ϯ 3 vs. 75 Ϯ 2 mmHg, P ϭ 0.04), mean BP (89 Ϯ 2 vs. 93 Ϯ 2 mmHg, P ϭ 0.02), MSNA (29 Ϯ 2 vs. 35 Ϯ 1 bursts/min, P Ͻ 0.01), and FVR (33 Ϯ 4 vs. 55 Ϯ 10 units, P ϭ 0.01), whereas it increased FBF (2.7 Ϯ 0.4 vs. 1.6 Ϯ 0.2 ml ⅐ min Ϫ1 ⅐ 100 ml Ϫ1 , P ϭ 0.02) and did not change HR (64 Ϯ 2 vs. 65 Ϯ 2 beats/min, P ϭ 0.3). Although ET did not change postexercise BP, HR, MSNA, FBF, or FVR responses, it reduced absolute HR values at baseline and after exercise. postmenopause; aerobic exercise; muscle sympathetic nerve activity; blood pressure THE POSTMENOPAUSAL PERIOD is accompanied by a number of physiological alterations (49). In postmenopausal women, blood pressure gradually increases (71), resulting in a considerably higher incidence of hypertension than that seen in premenopausal women (68). This difference has been attributed to abnormalities in arteriolar resistance caused by the absence of estrogen (48) and/or by physiological aging (1). Arteriolar resistance and hypertension are usually associated with an increase in sympathetic activity or responsiveness (33,64). However, the effects of menopause on sympathetic activity remain unclear. One recent study evaluated Polish and American women between 40 and 56 yr of age (50). The authors found that sympathetic activity in the postmenopausal women was similar to that observed in the premenopausal women. In contrast, the authors of a study conducted in Japan (46) observed higher sympathetic nerve activity in post-and premenopausal middle-aged women. Discrepancies in results might be related to many factors, such as ethnic background and diet.Postmenopausal women are often treated with hormone replacement therapy to minimize the symptoms and consequences of menopause. However, the effects of this therapy depend on the type and dose of hormone employed (31). Currently, many women are receiving natural estrogens, and the North American Menopause Society recommends that hormone replacement therapy should be administered in low doses to avoid any possible side effects (...

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Section: Discussionsupporting

confidence: 90%

“…Among previously normotensive women treated with hormone replacement therapy, blood pressure has been shown to decrease (4,5), increase (67,70), and be unaffected (57,60,66). Similarly, studies have shown hormone replacement therapy to reduce heart rate (HR) significantly (31,68), whereas others have shown that it has no effect on HR (51,68).…”

mentioning

confidence: 99%

Low-dose estrogen therapy does not change postexercise hypotension, sympathetic nerve activity reduction, and vasodilation in healthy postmenopausal women

Oneda

Forjaz²,

Bernardo³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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“…The current study used a double-blind, randomised, placebocontrolled design with adequate power to detect small changes in clinic and ambulatory blood pressure produced by different doses of a C21 progestogen administered in a cyclical regimen in doses spanning the usual clinical dose range combined with a fixed daily dose of oral oestrogen. The results of the current study are consistent with those of previous studies, including the PEPI study, which have found no change [2][3][4][5][6][7][8][9][10]12 or a reduction [24][25][26]29 in blood pressure associated with the addition of a progestogen to 'replacement' doses of oestrogen.…”

Section: Discussionsupporting

confidence: 91%

Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women

et al. 2001

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Objective: This study was designed to compare with placebo the dose-response effect of cyclical doses of the C21 progestogen, medroxyprogesterone acetate (MPA) on blood pressure (BP) when administered to normotensive postmenopausal women receiving a fixed mid-range daily dose of conjugated equine oestrogen (CEE). Materials and methods: Twenty normotensive postmenopausal women (median age 53 years) participated in the study which used a double-blind crossover design. There were four randomised treatment phases, each of 4 weeks duration. The four blinded treatments were MPA 2.5 mg, MPA 5 mg, MPA 10 mg and matching placebo, taken for the last 14 days of each 28 day treatment cycle. CEE 0.625 mg was also administered once daily as open labelled tablets to all subjects throughout the study. Clinic BP was measured weekly with the

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“…In women over the age of 60, show gradual increases of blood pressure over a period of 5 to 20 years, until hypertension is highly prevalent in women as in men. Estrogen reduction after menopause is partially responsible for this effect and experimental data indicate that the change in the estrogen/androgen ratio seems to be the cause (Akkad et al, 1997;Pripp et al, 1999). Epidemiological studies show that androgens are important determinants of sex differences in blood pressure.…”

Section: Role Of Androgens In Hypertensionmentioning

confidence: 99%

Cardiovascular Effects of Androgens

Wilson¹,

Maass²,

Estrada³

2011

Basic and Clinical Endocrinology Up-to-Date

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A randomized trial on effects of hormone therapy on ambulatory blood pressure and lipoprotein levels in women with coronary artery disease

Abstract: One year of HRT in patients with CAD does not influence ABP. Oral HRT induces beneficial effects on lipoprotein levels.

Cited by 45 publications

References 37 publications

Low-dose estrogen therapy does not change postexercise hypotension, sympathetic nerve activity reduction, and vasodilation in healthy postmenopausal women

Low-dose estrogen therapy does not change postexercise hypotension, sympathetic nerve activity reduction, and vasodilation in healthy postmenopausal women

Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women

Cardiovascular Effects of Androgens

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