Age-Related Deterioration in Arterial Structure and Function in Postmenopausal Women

McGrath, Barry P; Liang, Yu-Lu; Teede, Helena; Shiel, Louise; Cameron, James D.; Dart, Anthony M.

doi:10.1161/01.atv.18.7.1149

Cited by 122 publications

(82 citation statements)

References 58 publications

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“…Women receiving hormone replacement therapy had a higher systemic arterial compliance than controls (P Ͻ 0.0001). 47 These findings point to another mechanistic target for this therapeutic intervention.…”

Section: Postmenopausal Hormone Replacement Therapy and Vascular Compmentioning

confidence: 97%

Hypertension in women

Rosenthal

Oparil

2000

J Hum Hypertens

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Hypertension in women has received less attention than hypertension in men, and the major controlled trials of antihypertensive therapy have been carried out in populations made up predominantly of and have emphasised outcomes in men. Recently it has been recognised that women develop high blood pressure, particularly systolic hypertension, at an increased rate as they age, and that this age-related blood pressure increase is exaggerated by the menopause. The age-related rise in blood pressure, particularly systolic blood pressure and pulse pressure, contributes substantially to the age-related increase in risk of heart attack, heart failure, and stroke in middle-aged and elderly women. This article reviews

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Section: Postmenopausal Hormone Replacement Therapy and Vascular Compmentioning

confidence: 97%

Hypertension in women

Rosenthal

Oparil

2000

J Hum Hypertens

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“…The menopausal status and the use of a hormone replacement therapy, which are known to affect large artery elastic properties, 36 were not available in the present PXE cohort and control group. Because menopause occurs between 45 and 55 years of age and because IMT was higher in older patients with PXE than in older controls, we performed a first comparison in women older than 45 years and a second one in women older than 55 years.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Arterial Remodeling and Stiffness in Patients With Pseudoxanthoma Elasticum

Germain

Boutouyrie

Laloux

et al. 2003

ATVB

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Objective-Proteoglycans organize the extracellular matrix, act as signaling molecules, and are involved in cell migration and proliferation. They may play an important role in arterial geometric and elastic properties. The aim of the present study was to determine large artery phenotype in patients with pseudoxanthoma elasticum (PXE), a genetic disease characterized by proteoglycan accumulation and fragmented elastic fibers in connective tissues. Methods and Results-In 27 patients with PXE (25 females and 2 male) and 27 control subjects matched by age, sex, and blood pressure, we noninvasively determined the common carotid and radial artery diameter, intima-media thickness (IMT), and distensibility with high-definition echo-tracking systems and applanation tonometry. Patients with PXE had a significantly higher carotid IMT (611Ϯ106 versus 520Ϯ76 m, PϽ0.001) independently of body surface area, age, and mean blood pressure. The increase in carotid IMT predominated in older patients with PXE at the time of examination. No significant difference in carotid elastic properties was observed between patients with PXE and control subjects. At the site of the radial artery, distensibility was significantly higher in patients with PXE than in control subjects (11.6Ϯ11.

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“…Studies in healthy postmenopausal women suggest hormone replacement therapy (HRT) use may have favorable effects on large artery compliance. [15][16][17][18] However, these effects may be limited to specific formulations of HRT 17,19 or certain subgroups of women. 19 Furthermore, aging, established atherosclerosis, 20 or concomitant progestin use 21 may attenuate some of the favorable effects of estrogen on vasculature.…”

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confidence: 99%

Pulse Pressure and Coronary Atherosclerosis Progression in Postmenopausal Women

et al. 2005

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Abstract-Pulse pressure, an index of large artery stiffness, has been associated with coronary events. However, mechanisms for this association remain unclear. In this study, we examined the relationship between pulse pressure and the progression of coronary atherosclerosis and the effects of hormone replacement therapy (HRT) on pulse pressure in postmenopausal women with angiographically confirmed coronary disease followed for 3.2 years in the Estrogen Replacement in Atherosclerosis (ERA) trial. In the ERA trial, 309 postmenopausal women (mean age 66Ϯ7 years) with coronary disease were randomized to estrogen, estrogen plus progestin, or placebo, and followed for 3.2 years. Ten standardized epicardial segments were measured for minimal diameter values at baseline and follow-up using quantitative coronary angiography. For this study, mixed-model analysis of covariance was used to: (1) test the association between pulse pressure and change in mean minimum diameter (MMD) adjusted for baseline MMD and (2) the effect of HRT on follow-up pulse pressure. After adjustment for potential confounders, there was a significant graded increase in progression of coronary stenosis with increasing quartiles of baseline pulse pressure (P test for trendϭ0.0001). The progression rate in women with the highest quartile of baseline pulse pressure was 5-fold higher than in women in the lowest quartile (PϽ0.01). In postmenopausal women with coronary disease, increased levels of baseline pulse pressure are associated with subsequent progression of coronary atherosclerosis in postmenopausal women. HRT had no detectable effect on pulse pressure. Key Words: pulse Ⅲ atherosclerosis Ⅲ women P ulse pressure, an index of large artery stiffness, 1 is a significant predictor of coronary artery disease outcomes, including myocardial infarction 2-5 and restenosis after percutaneous coronary intervention. 6 However, the mechanisms underlying this association remain to be elucidated. In animal models, increased aortic stiffness is associated with coronary ischemia 7 and progression of coronary atherosclerosis. 8 In clinical studies, increased pulse pressure (PP) has been associated with atherosclerosis progression in the aorta 9,10 and carotid arteries, 11-14 but its relationship to coronary atherosclerosis progression in humans remains unknown.Any association between PP and coronary atherosclerosis progression in women may be confounded by hormonal status. Studies in healthy postmenopausal women suggest hormone replacement therapy (HRT) use may have favorable effects on large artery compliance. [15][16][17][18] However, these effects may be limited to specific formulations of HRT 17,19 or certain subgroups of women. 19 Furthermore, aging, established atherosclerosis, 20 or concomitant progestin use 21 may attenuate some of the favorable effects of estrogen on vasculature. Additional studies are needed to examine the association of PP with coronary atherosclerosis progression in postmenopausal women and assess the impact of HRT use on PP.In this stu...

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Age-Related Deterioration in Arterial Structure and Function in Postmenopausal Women

Cited by 122 publications

References 58 publications

Hypertension in women

Hypertension in women

Arterial Remodeling and Stiffness in Patients With Pseudoxanthoma Elasticum

Pulse Pressure and Coronary Atherosclerosis Progression in Postmenopausal Women

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