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

Abstract

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

Estrogen and hypertension

“…One cross-sectional study in normotensive postmenopausal women demonstrated higher ambulatory BP in women treated with a combination of transdermal estrogen and norethisterone than in women treated with estrogen alone [72]. However, prospective studies failed to confirm this finding and even suggested dose-dependent BP-lowering effects of androgenic progestins [73,74]. Similarly, natural progesterone has not been found to interfere with the BP-lowering effect of transdermal estrogen [31].…”

Sex Hormones and Vascular Function

“…Similarly, medroxyprogesterone acetate (MPA) appears to have BP neutral or lowering effects. In a double-blind, crossover study of postmenopausal women assigned to CEE and placebo or increasing doses of MPA, there was a dosedependent decrease in ambulatory daytime diastolic and mean BPs for women assigned to the progestin compared with placebo (Harvey et al, 2001). In contrast, most studies of synthetic progestins for contraception or hormone therapy have revealed a BP-elevating effect.…”