Effect of hormone replacement therapy on QT interval

Larsen, Jennifer A.; Tung, Roderick; Sadananda, Ramana; Parker, M. A.; Goldberger, J.; Horvath, George; Kadish, Alan H.

doi:10.1016/s0735-1097(98)81792-0

Cited by 4 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is also a gender-specific difference in mRNA for both α- and β-myosin heavy chains, actin and myocardial connective tissue proteins [5]. Moreover, in female myocardium estrogen receptors modulate cardiovascular diseases and cardiac β 1 -receptors are upregulated in case of estrogen deficiency [6,7,8,9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

Cocco¹,

Chu²

2006

Cardiology

View full text Add to dashboard Cite

Several gender-specific differences in cardiovascular diseases are known and pharmacokinetics of β-blockers shows relevant sex-specific differences. The plasma levels of metoprolol, for example, are higher in women compared to men. However, randomized studies have shown that metoprolol has little or no greater reduction in the mortality of women following myocardial infarction. We tested the hypothesis that metoprolol might have significant gender-specific effects in patients with chronic angina pectoris. Body weight of women was slightly (–9%) less than that of men and the daily dose of metoprolol was similar in both groups. Thus, according to pharmacokinetics women should have obtained higher plasma levels of this drug and the ensuing pharmacologic effects of metoprolol should have been greater. Our results do not confirm this assumption. Metoprolol reduced the frequency of angina episodes and the consumption of nitroglycerin tablets to a similar extent in both sexes. However, the pretreatment hemodynamic profiles confirmed the existence of gender-specific differences: women had significantly higher heart rate and blood pressure both at rest and during exercise. Since both groups were comparable in age, comorbidities, and medications, the existing difference is likely to be due to gender-specificity. The hemodynamic differences persisted during therapy with metoprolol: resting heart rate, blood pressure and rate pressure product were reduced to a greater extent in men. During cycloergometry, there was a slight difference in the time of onset of ST depression and time of onset of angina, which were slightly higher in men, but probably because of the limited number of cases, the difference between men and women did not reach significance. On the other hand, with metoprolol the duration of exercise and, in parallel, the number of metabolic equivalents was significantly greater in males than in females. Thus in spite of a presumed greater plasma concentration of metoprolol in women, we found a significant difference in anti-ischemic effect in favor of men. We conclude that metoprolol might exert a significantly greater therapeutic effect on stress-induced angina pectoris in men than in women and this difference should be taken into account when prescribing this β-blocker.

show abstract

Section: Introductionmentioning

confidence: 99%

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

Cocco¹,

Chu²

2006

Cardiology

View full text Add to dashboard Cite

show abstract

Beyond women's health

Legato

2003

Medical Clinics of North America

View full text Add to dashboard Cite

Absence of Effects of Short‐Term Estrogen Replacement Therapy on Resting and Exertional QT and QT_c Dispersion in Postmenopausal Women with Coronary Artery Disease

Sbarouni

Zarvalis

Kyriakides

et al. 1998

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Women, on average, have a longer QT interval on the electrocardiogram and are at higher risk of developing torsade de pointes from antiarrhythmic therapy than men. Although endogenous estrogen may play a role in these sex differences, the effect of estrogen replacement therapy has not been examined. Ten women, 65 +/- 7 years of age, with stable angina pectoris, positive exercise test, and angiographically proven coronary artery disease (at least one > or = 70%) stenosis were studied. All women had been postmenopausal for at least 1 year, and none had ever received hormone replacement therapy (HRT). The patients received standard dose HRT (0.625 mg/day oral conjugated estrogen) or matching placebo for 4 weeks in random order, with crossover after a 4-week washout period. Exercise testing using the standard Bruce protocol was performed at the end of the first and third months of the study. Antianginal medications remained unchanged throughout the study period. Compared to placebo, HRT caused a significant increase in plasma estradiol levels from 5.55 +/- 1.66 to 31.11 +/- 14.95 pg/mL (P = 0.001). QT and QTc, as well as QT and QTc dispersion, did not differ at rest and at peak exercise between the two exercise tests. Likewise, other test results, including angina score, exercise time, ST-T changes, blood pressure, heart rate, and double product were unchanged. Short-term HRT did not alter cardiac repolarization at rest and during exercise in postmenopausal women with known coronary disease.

show abstract

Effect of hormone replacement therapy on QT interval

Cited by 4 publications

References 0 publications

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

Beyond women's health

Absence of Effects of Short‐Term Estrogen Replacement Therapy on Resting and Exertional QT and QT_c Dispersion in Postmenopausal Women with Coronary Artery Disease

Contact Info

Product

Resources

About

Effect of hormone replacement therapy on QT interval

Cited by 4 publications

References 0 publications

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

The Anti-Ischemic Effect of Metoprolol in Patients with Chronic Angina Pectoris Is Gender-Specific

Beyond women's health

Absence of Effects of Short‐Term Estrogen Replacement Therapy on Resting and Exertional QT and QTc Dispersion in Postmenopausal Women with Coronary Artery Disease

Contact Info

Product

Resources

About

Absence of Effects of Short‐Term Estrogen Replacement Therapy on Resting and Exertional QT and QT_c Dispersion in Postmenopausal Women with Coronary Artery Disease