The effect of hormone replacement therapy on diastolic left ventricular function in hypertensive and normotensive postmenopausal women

Beljic, Teodora; Babić, Dragan; Marinković, Jelena; Prelević, Gordana M.

doi:10.1016/s0378-5122(98)00030-9

Cited by 25 publications

(10 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both estradiol alone and estradiol plus progesterone were shown by Seely et al [29] to decrease blood pressure in 15 normotensive postmenopausal women when 24-hour ambulatory blood pressure monitoring was used. In agreement, Beljic et al [30] reported that 12-month HRT decreased systolic pressure measured in the office setting in 19 normotensive postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) trial [10••] studied 875 normotensive women (mean blood pressure, 115/72 mm) and did not find a significant reduction in systolic or diastolic blood pressure during the first year of treatment.…”

Section: Hormone Replacement Therapysupporting

confidence: 63%

“…Manhem et al [32] reported a small reduction in systolic blood pressure in 13 hypertensive postmenopausal women during the first 24 hours after transdermal estrogen therapy, although the decrease in pressure was noted only during the daytime with ambulatory blood pressure measurements. In contrast, 12-month HRT did not decrease systolic pressure in 11 hypertensive postmenopausal women [30]. Lip et al [33] also reported no changes in systolic or diastolic blood pressure in 75 postmenopausal hypertensive women receiving HRT for 14 months.…”

Section: Hormone Replacement Therapymentioning

confidence: 95%

See 1 more Smart Citation

Postmenopausal hypertension

Harrison‐Bernard

Raij

2000

Current Science Inc

View full text Add to dashboard Cite

Cardiovascular disease is the leading cause of death in women and claims the lives of more than half a million women every year. Hypertension is one of the most prevalent and powerful contributors to atherosclerotic cardiovascular disease. Hypertension affects more men than women until 55 years of age, but after age 55, the percentage of women is higher. Estrogen deficiency has been linked to the rapid increase in cardiovascular disease in women who have undergone natural or surgical menopause. Hormone replacement therapy (HRT) has been shown to decrease the incidence of cardiovascular disease and, in some studies, to reduce blood pressure in postmenopausal women. However, little information is available on the effects of HRT on blood pressure in hypertensive postmenopausal patients. The cardioprotective effects of estrogens are not completely understood but may involve direct effects on blood vessels through modulation of endogenous vasoconstrictors and vasodilators and through reductions in serum lipoprotein and cholesterol levels. Experimental evidence suggests that estrogen increases the biological actions of nitric oxide and decreases the actions of angiotensin. After menopause, loss of the vascular protective effects of estrogens may unmask a population of women particularly prone to hypertension who would be at higher risk for cardiovascular disease.

show abstract

Section: Hormone Replacement Therapysupporting

confidence: 63%

Section: Hormone Replacement Therapymentioning

confidence: 95%

Postmenopausal hypertension

Harrison‐Bernard

Raij

2000

Current Science Inc

View full text Add to dashboard Cite

show abstract

“…In these studies, blood pressure was not affected by HRT, [33][34][35] was only minimally affected by HRT, 36 -38 or the reduction in blood pressure with HRT was evident only at night 38 or only in normotensive individuals. 39 Furthermore, the route of delivery was important in whether HRT was effective in lowering blood pressure, with transdermal HRT being more effective than oral preparations. 34,38 Importantly, the Heart and Estrogen/Progestin Replacement Study (HERS) also found that there was no overall beneficial effect on secondary prevention of coronary heart disease in postmenopausal women during the 4.1 years of study.…”

Section: Hormone Replacement Therapy In Postmenopausal Womenmentioning

confidence: 99%

Gender Differences in the Regulation of Blood Pressure

2001

View full text Add to dashboard Cite

Abstract-Men are at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women.Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages. After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women. In this review the possible mechanisms by which androgens may increase blood pressure are discussed. Findings in animal studies show that there is a blunting of the pressure-natriuresis relationship in male spontaneously hypertensive rats and in ovariectomized female spontaneously hypertensive rats treated chronically with testosterone. The key factor in controlling the pressure-natriuresis relationship is the renin-angiotensin system (RAS). The possibility that androgens increase blood pressure via the RAS is explored, and the possibility that the RAS also promotes oxidative stress leading to production of vasoconstrictor substances and reduction in nitric oxide availability is proposed. Key Words: sex characteristics Ⅲ hypertension Ⅲ angiotensin II Ⅲ nitric oxide Ⅲ oxidative stress I n this review gender differences in blood pressure control are explored, including possible mechanisms by which androgens may increase blood pressure. Gender Differences in Blood Pressure Regulation in HumansMen are generally at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women. Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages. As shown in Figure 1, Wiinber and colleagues 1 studied 352 normotensive (for age) Danish men and women, aged 20 to 79 years, and found that blood pressure increased with aging in both men and women, but that men had higher 24-hour mean blood pressure, by approximately 6 to 10 mm Hg, than did women, until the age of 70 to 79 years, when blood pressure was similar for men and women. Khoury and colleagues 2 performed ambulatory blood pressure monitoring on 131 men and women, aged 50 to 60 years, and found that men had higher blood pressure than did women. Findings were similar in a meta-analysis study performed by Staessen et al. 3 In addition, the Third National Health and Nutrition Evaluation Survey (NHANES III) showed that, in general, men had higher blood pressure than women through middle age. 4 Furthermore, the incidence of uncontrolled hypertension is also greater in men than in women. 5After menopause, however, blood pressure increases in women as well. The data from NHANES III, shown in Figure 2, confirmed that by 60 to 69 years of age, non-Hispanic black and Hi...

show abstract

“…Parameters of mitral flow depend on arterial impedance and blood pressure. Our previous studies have shown that an improvement in diastolic flow can be achieved in hypertensive women on HRT, which indicates a possible direct effect of estrogens on cardiac muscle 33 . Despite decreased blood pressure, there was no significant effect on diastolic function in smokers.…”

Section: Discussionmentioning

confidence: 86%