Effects of transdermal estrogens on endothelial function in postmenopausal women with coronary disease

Blümel, Juan E.; Castelo-Branco, Camil; Leal, Tatiana de Carvalho Andreucci Torres; Pérez-Gallardo, L.; Saini, J.; Ferron, S.; Haya, Javier

doi:10.1080/713605340

Cited by 5 publications

(3 citation statements)

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“…Resting heart rate, mean arterial blood pressure and baseline brachial arterial diameter, were similar between the groups, yet mean percent change from baseline brachial artery diameter in response to flow mediated dilation in AM and EU athletes was 1.08 ± 0.91% and 6.38 ± 1.38 %, respectively [11]. Alarmingly, the magnitude of impaired brachial endothelium-dependent vasodilation in AM athletes is comparable to data previously reported in otherwise healthy postmenopausal women [177] and older [60 ± 2yr] coronary artery diseased patients [178] after a similar flow-mediated stimulus. Since endothelial dysfunction is a predictor of future coronary events [179], the finding from Zeni-Hoch and colleagues [11], is suggestive of increased risk for accelerated cardiovascular disease development in AM compared to EU athletes [11].…”

Section: Nitric Oxide and Am Athletessupporting

confidence: 69%

The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes

O’Donnell

Souza

2004

Sports Medicine

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In premenopausal women, the most severe menstrual dysfunction is amenorrhea and is associated with chronic hypoestrogenism. In postmenopausal women, the coincident hypoestrogenism observed is associated with a number of clinical sequelae related to cardiovascular health. Due to an observed cardioprotective effect of E2, persistently low E2 levels in amenorrheic (AM) athletes may confer deleterious effects on cardiovascular health.The incidence of amenorrhea among athletes is much greater than that observed among sedentary women. Recent data in AM athletes demonstrate impaired endothelial function, elevated low-and high-density lipoprotein levels, reduced circulating nitrates and nitrites, and increased susceptibility to lipid peroxidation. An improvement in endothelial function has also been reported during the recovery of menstrual cyclicity in a small sample of previously AM athletes. Although no longitudinal studies exist, these findings are suggestive of increased risk of premature cardiovascular disease in AM athletes. These issues are explored and discussed in detail in this comprehensive review paper. Future research should focus on the presentation and progression of these adverse cardiovascular parameters in physically active women and athletes with hypoestrogenism to determine their effect on long-term health outcomes.

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Section: Nitric Oxide and Am Athletessupporting

confidence: 69%

The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes

O’Donnell

Souza

2004

Sports Medicine

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“…Alarmingly, the severity of endothelial dysfunction in EAA (38,45,46) is similar to that previously observed in postmenopausal women (6) and coronary artery diseased patients (7). Reversibility of endothelial dysfunction with oral contraceptive therapy to women with EAA has been reported (38).…”

supporting

confidence: 63%

Long-term estrogen deficiency lowers regional blood flow, resting systolic blood pressure, and heart rate in exercising premenopausal women

O’Donnell

Harvey²,

Goodman³

et al. 2007

American Journal of Physiology-Endocrinology and Metabolism

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The cardiovascular consequences of hypoestrogenism in premenopausal women are unclear. Accordingly, the influence of menstrual status and endogenous estrogen (E2) exposure on blood pressure (BP), heart rate (HR), and calf blood flow in young (18 -35 yr) regularly exercising premenopausal women with exercise-associated menstrual aberrations was investigated. Across consecutive menstrual cycles, daily urinary ovarian steroid levels were analyzed, and the area under the curve was calculated to determine menstrual status and E2 exposure. BP, HR, blood flow, vascular conductance, and resistance were measured at baseline and following ischemic calf exercise. Exercising subjects consisted of 14 ovulatory (ExOv), 10 short-term (anovulatory and Յ100 days amenorrhea; ST-E 2 Def), and 8 long-term (Ͼ100 days amenorrhea; LT-E2 Def) E2-deficient women. Nine sedentary ovulatory subjects (SedOv) were also studied. All groups were similar in age (24.8 Ϯ 0.7 yr), height (164.8 Ϯ 1.3 cm), weight (57.9 Ϯ 0.9 kg), and body mass index (21.3 Ϯ 0.3 kg/m 2 ). E2-deficient groups had lower (P Ͻ 0.002) E2 exposure compared with ovulatory groups. Resting systolic BP, HR, blood flow, and vascular conductance were lower (P Ͻ 0.05) and vascular resistance higher (P Ͻ 0.05) in LT-E2 Def compared with both ovulatory groups. Peak ischemic blood flow, vascular conductance, and HR were also lower (P Ͻ 0.05) and vascular resistance higher (P Ͻ 0.05) in LT-E2 Def compared with all other groups. Our findings show that exercising women with longterm E2 deficiency have impaired regional blood flow and lower systolic BP and HR compared with exercising and sedentary ovulatory women. These cardiovascular alterations represent markers of altered vascular function and autonomic regulation of which the long-term effects remain unknown.exercise-associated amenorrhea; menstrual aberrations; vascular resistance EXERCISE-ASSOCIATED AMENORRHEA (EAA) is the most severe of menstrual disturbances (10, 11). The etiology of EAA is linked to chronic energy deficiency that is communicated as inhibitory signals to the reproductive axis (11). Chronic suppression of ovarian steroids in postmenopausal women is associated with an increased risk of premature chronic diseases, including cardiovascular disease (9). Little is known of the short-and long-term cardiovascular consequences of hypoestrogenism in otherwise healthy premenopausal exercising women.Preliminary data suggest that women with EAA may develop a proatherogenic phenotype, including increases in total cholesterol, low density lipoprotein (LDL)-cholesterol, and apolipoprotein (apo)B, with concurrent decreases in apoAI and the apoAI-to-apoB ratio (24, 38), increased susceptibility of LDL-cholesterol to peroxidation (2), and impaired brachial artery endothelium-dependent flow-mediated vasodilation (38,45,46). Alarmingly, the severity of endothelial dysfunction in EAA (38,45,46) is similar to that previously observed in postmenopausal women (6) and coronary artery diseased patients (7). Reversibility of endothelial d...

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“…Nevertheless, an increased risk for high blood pressure with oral formulations or a beneficial effect of transdermal estradiol on blood pressure has not been confirmed in clinical studies 19,21. Moreover, transdermal estradiol improved endothelial function in postmenopausal women with coronary artery disease when compared with placebo 22. Finally, transdermal estradiol formulations seem to have a better effect on the prevention of atherosclerosis 23.…”

Section: Estrogens and Progestinsmentioning

confidence: 99%

Off-label use of hormones as an antiaging strategy: a review

Samaras¹,

Papadopoulou²,

Samaras³

et al. 2014

CIA

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Given demographic evolution of the population in modern societies, one of the most important health care needs is successful aging with less frailty and dependency. During the last 20 years, a multitude of anti-aging practices have appeared worldwide, aiming at retarding or even stopping and reversing the effects of aging on the human body. One of the cornerstones of anti-aging is hormone replacement. At present, women live one third of their lives in a state of sex-hormone deficiency. Men are also subject to age-related testosterone decline, but andropause remains frequently under-diagnosed and under-treated. Due to the decline of hormone production from gonads in both sexes, the importance of dehydroepiandrosterone (DHEA) in steroid hormone production increases with age. However, DHEA levels also decrease with age. Also, growth hormone age-associated decrease may be so important that insulin growth factor-1 levels found in elderly individuals are sometimes as low as those encountered in adult patients with established deficiency. Skin aging as well as decreases in lean body mass, bone mineral density, sexual desire and erectile function, intellectual activity and mood have all been related to this decrease of hormone production with age. Great disparities exist between recommendations from scientific societies and actual use of hormone supplements in aging and elderly patients. In this article, we review actual data on the effects of age related hormone decline on the aging process and age-related diseases such as sarcopenia and falls, osteoporosis, cognitive decline, mood disorders, cardiovascular health and sexual activity. We also provide information on the efficiency and safety of hormone replacement protocols in aging patients. Finally, we argue on future perspectives of such protocols as part of everyday practice.

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Effects of transdermal estrogens on endothelial function in postmenopausal women with coronary disease

Abstract: Transdermal estrogen may improve endothelial function in women with coronary heart disease.

Cited by 5 publications

References 0 publications

The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes

The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes

Long-term estrogen deficiency lowers regional blood flow, resting systolic blood pressure, and heart rate in exercising premenopausal women

Off-label use of hormones as an antiaging strategy: a review

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