Hormone therapy and antioxidant vitamins do not improve endothelial vasodilator function in postmenopausal women with established coronary artery disease: a substudy of the Women's Angiographic Vitamin and Estrogen (WAVE) trial

Kelemen, Mark D.; Vaidya, Dhananjay; Waters, David D.; Howard, Barbara V.; Cobb, Frederick R.; Younes, Naji; Tripputti, Mark; Ouyang, Pamela

doi:10.1016/j.atherosclerosis.2004.09.021

Cited by 47 publications

(26 citation statements)

References 32 publications

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“…However, this was not found in women with Hp 2-2 allelle. In contrast, neither flow-mediated, endothelium-dependent dilation, nor nitroglycerin-induced vasodilation was improved in any of the women taking vitamins E and C in this trial (33). These data suggest that there may be a genetic component involved in the mechanisms by which oxidative stress mediates cardiovascular disease.…”

Section: Other Considerations In Human Studiescontrasting

confidence: 55%

Sex differences in control of blood pressure: role of oxidative stress in hypertension in females

Lopez‐Ruiz¹,

Sartori‐Valinotti²,

Yanes³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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Lopez-Ruiz A, Sartori-Valinotti J, Yanes LL, Iliescu R, Reckelhoff JF. Sex differences in control of blood pressure: role of oxidative stress in hypertension in females. Am J Physiol Heart Circ Physiol 295: H466 -H474, 2008. First published June 20, 2007 doi:10.1152/ajpheart.01232.2007.-In general, blood pressure is higher in normotensive men than in age-matched women, and the prevalence of hypertension in men is also higher until after menopause, when the prevalence of hypertension increases for women. It is likely then that the mechanisms by which blood pressure increases in men and women with aging may be different. Although clinical trials to reduce blood pressure with antioxidants have typically not been successful in human cohorts, studies in male rats suggest that oxidative stress plays an important role in mediating hypertension. The exact mechanisms by which oxidative stress increases blood pressure have not been completely elucidated. There may be several reasons for the discrepancies between clinical and animal studies. In this review, the data obtained in selected clinical and animal studies are discussed, and the hypothesis is put forward that oxidative stress may not be as important in mediating hypertension in females as has been shown previously in male rats. Furthermore, it is likely that differences in genetics, age, length of time with hypertension, endothelial dysfunction, and sex are all factored in to modulate the responses to antioxidants in humans. As such, future clinical trials should be designed and powered to evaluate the effects of oxidative stress on blood pressure separately in men and women.F 2-isoprostanes WITH THE USE OF AMBULATORY blood pressure monitoring, it is now well accepted that blood pressure is higher in men than age-matched premenopausal women, and that, following menopause, this trend reverses, such that the incidence of hypertension in postmenopausal women is similar to or higher than in men (5, 69). A comparison of the data from the National Health and Nutrition Examination Survey (NHANES) III (1988III ( -1994 with data from NHANES IV (1999 -2002) revealed that the prevalence of hypertension is currently stable in men, and their blood pressures are well controlled with medication. In contrast, in women, the incidence of hypertension is progressively increasing, and blood pressure is often higher in women than in age-matched men (35). Furthermore, blood pressure in women is not well controlled with medication, despite typically higher levels of compliance compared with men (35). These disturbing statistics suggest that mechanisms responsible for hypertension in men and women may be different, and it is imperative that physicians and scientists begin to determine what these differences are to better treat hypertension in both men and women. Oxidative Stress and Hypertension in Humans: Clinical TrialsThe role that oxidative stress plays in mediating hypertension has been the focus of a significant amount of research in recent years. Several clinical trials have be...

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Section: Other Considerations In Human Studiescontrasting

confidence: 55%

Sex differences in control of blood pressure: role of oxidative stress in hypertension in females

Lopez‐Ruiz¹,

Sartori‐Valinotti²,

Yanes³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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“…Concomitant administration of progestins, such as medroxyprogesterone acetate (MPA) and norethisterone acetate, has been shown to attenuate estrogen-induced increase in the production of nitric oxide [45] and prostacyclin [46] in endothelial cell cultures. In vivo studies suggest that administration of estradiol alone tends to improve coronary and peripheral endothelial function in postmenopausal women [47,48], whereas studies using a combination of oral or transdermal estrogens with progestins frequently failed to show improvement of endothelial function [16,49,50]. However, larger studies are needed to directly compare the effects of estrogen alone to combined estrogen and progestins on endothelial function before definitive conclusion can be made.…”

Section: Confounding Influence Of Progesterone or Progestins On Bp Rementioning

confidence: 99%

Estrogen and hypertension

Ashraf

Vongpatanasin²

2006

Current Science Inc

140

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Menopause is accompanied by a dramatic rise in the prevalence of hypertension in women, suggesting a protective role of endogenous estradiol on blood pressure (BP). Both animal experimental and human clinical investigations suggest that estrogen engages several mechanisms that protect against hypertension, such as activation of the vasodilator pathway mediated by nitric oxide and prostacyclin and inhibition of the vasoconstrictor pathway mediated by the sympathetic nervous system and angiotensin. However, emerging evidence from recent clinical trials indicates a small increase, rather than decrease, in systolic BP with oral estrogen administration in postmenopausal women, without any detectable effect on diastolic BP. Mechanisms underlying this selective rise in systolic BP in postmenopausal women and oral contraceptive-induced hypertension in premenopausal women remain unknown, but the rise may be related to supraphysiologic concentration of estrogen in the liver. To date, transdermal delivery of estrogen, which avoids the first-pass hepatic metabolism of estradiol, appears to have a small BP-lowering effect in postmenopausal women and may be a safer alternative in hypertensive women.

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“…Die HERS-, ERA-, WEST-und WHI-Studien [19] haben den durch frühere Beobachtungsstudien beförderten Glauben an den Schutz des Herzens durch Hormonsubstitution ins Wanken gebracht. Auch in der kürzlich auf der Tagung der American Heart Association in Chicago vorgestellten WAVE (Women's Angiogaphic Vitamin and Estrogen)-Studie [14] zeigte sich kein Nutzen einer auf Sekundärprä-vention zielenden Hormonsubstitution. Sogar die zusätzliche Supplementierung von antioxidativen Vitaminen war wirkungslos und sogar potenziell schädlich.…”

Section: Hormonersatztherapieunclassified

Das Herz bei endokrinen Erkrankungen

2007

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Hormonal regulation is not possible without the cardiovascular system, and thus the heart plays a special role not only in the action and synthesis, but also in the distribution of hormones. Severe endocrine disorders with cardiac involvement are often threatening for the patient. The impact of aberrant thyroid function, the sympathetic-adrenal symptoms of which predominantly affect the heart, is well known. Diabetes mellitus and the associated metabolic syndrome are major causes of cardiovascular disease and determine its morbidity and lethality rates. Acromegaly causes a complex cardiomyopathy that may result in cardiac failure refractive to conventional treatment. The excessive production of adrenal hormones in Cushing's syndrome, hyperaldosteronism and pheochromocytoma primarily harms the heart by causing severe hypertension. The same holds true for long-standing hyperparathyroidism. Recent prospective studies did not confirm the protective effect of hormone replacement therapy on cardiovascular disease.

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Hormone therapy and antioxidant vitamins do not improve endothelial vasodilator function in postmenopausal women with established coronary artery disease: a substudy of the Women's Angiographic Vitamin and Estrogen (WAVE) trial

Cited by 47 publications

References 32 publications

Sex differences in control of blood pressure: role of oxidative stress in hypertension in females

Sex differences in control of blood pressure: role of oxidative stress in hypertension in females

Estrogen and hypertension

Das Herz bei endokrinen Erkrankungen

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