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Endothelial function in women of the Kronos Early Estrogen Prevention Study.

Kling JM, Lahr BA, Bailey KR, Harman SM, Miller VM, Mulvagh SL - Climacteric (2015)

Bottom Line: At baseline, RHI averaged 2.39 ± 0.69 (mean ± standard deviation; n = 83), and over follow-up did not differ significantly among groups: oCEE, 2.26 ± 0.48 (n = 26); tE2, 2.26 ± 0.45 (n = 24); and placebo, 2.37 ± 0.37 (n = 33).Changes in RHI did not correlate with changes in traditional cardiovascular risk factors, but may inversely correlate with carotid intima medial thickness (Spearman correlation coefficient ρ = -0.268, p = 0.012).In this 4-year prospective assessment of recently menopausal women, MHT did not significantly alter RHI when compared to placebo.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine Mayo Clinic Scottsdale , USA.

ABSTRACT

Objective: Endothelial dysfunction occurs early in the atherosclerotic disease process, often preceding clinical symptoms. Use of menopausal hormone treatment (MHT) to reduce cardiovascular risk is controversial. This study evaluated effects of 4 years of MHT on endothelial function in healthy, recently menopausal women.

Methods: Endothelial function was determined by pulse volume digital tonometry providing a reactive hyperemia index (RHI) in a subset of women enrolled in the Kronos Early Estrogen Prevention Study. RHI was measured before and annually after randomization to daily oral conjugated equine estrogen (oCEE, 0.45 mg), weekly transdermal 17β-estradiol (tE2, 50 μg) each with intermittent progesterone (200 mg daily 12 days of the month) or placebo pills and patch.

Results: At baseline, RHI averaged 2.39 ± 0.69 (mean ± standard deviation; n = 83), and over follow-up did not differ significantly among groups: oCEE, 2.26 ± 0.48 (n = 26); tE2, 2.26 ± 0.45 (n = 24); and placebo, 2.37 ± 0.37 (n = 33). Changes in RHI did not correlate with changes in traditional cardiovascular risk factors, but may inversely correlate with carotid intima medial thickness (Spearman correlation coefficient ρ = -0.268, p = 0.012).

Conclusion: In this 4-year prospective assessment of recently menopausal women, MHT did not significantly alter RHI when compared to placebo.

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Related in: MedlinePlus

Representation of actual reactive hyperemia index (RHI) values over time by treatment group. Each line represents an individual. BL, baseline
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Figure 1: Representation of actual reactive hyperemia index (RHI) values over time by treatment group. Each line represents an individual. BL, baseline

Mentions: There was no significant change in RHI over the 4-year follow-up period within any of the treatment groups or in the full combined set of participants. The variability in longitudinal RHI measurements within participants was high in each treatment group (within-subject standard deviations and CV%, averaged: 0.41 and 18.3% in the tE2 group, 0.49 and 20.5% in the oCEE group, and 0.50 and 20.5% in the placebo group) and did not differ significantly across groups (Figure 1, p = 0.31).


Endothelial function in women of the Kronos Early Estrogen Prevention Study.

Kling JM, Lahr BA, Bailey KR, Harman SM, Miller VM, Mulvagh SL - Climacteric (2015)

Representation of actual reactive hyperemia index (RHI) values over time by treatment group. Each line represents an individual. BL, baseline
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389699&req=5

Figure 1: Representation of actual reactive hyperemia index (RHI) values over time by treatment group. Each line represents an individual. BL, baseline
Mentions: There was no significant change in RHI over the 4-year follow-up period within any of the treatment groups or in the full combined set of participants. The variability in longitudinal RHI measurements within participants was high in each treatment group (within-subject standard deviations and CV%, averaged: 0.41 and 18.3% in the tE2 group, 0.49 and 20.5% in the oCEE group, and 0.50 and 20.5% in the placebo group) and did not differ significantly across groups (Figure 1, p = 0.31).

Bottom Line: At baseline, RHI averaged 2.39 ± 0.69 (mean ± standard deviation; n = 83), and over follow-up did not differ significantly among groups: oCEE, 2.26 ± 0.48 (n = 26); tE2, 2.26 ± 0.45 (n = 24); and placebo, 2.37 ± 0.37 (n = 33).Changes in RHI did not correlate with changes in traditional cardiovascular risk factors, but may inversely correlate with carotid intima medial thickness (Spearman correlation coefficient ρ = -0.268, p = 0.012).In this 4-year prospective assessment of recently menopausal women, MHT did not significantly alter RHI when compared to placebo.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine Mayo Clinic Scottsdale , USA.

ABSTRACT

Objective: Endothelial dysfunction occurs early in the atherosclerotic disease process, often preceding clinical symptoms. Use of menopausal hormone treatment (MHT) to reduce cardiovascular risk is controversial. This study evaluated effects of 4 years of MHT on endothelial function in healthy, recently menopausal women.

Methods: Endothelial function was determined by pulse volume digital tonometry providing a reactive hyperemia index (RHI) in a subset of women enrolled in the Kronos Early Estrogen Prevention Study. RHI was measured before and annually after randomization to daily oral conjugated equine estrogen (oCEE, 0.45 mg), weekly transdermal 17β-estradiol (tE2, 50 μg) each with intermittent progesterone (200 mg daily 12 days of the month) or placebo pills and patch.

Results: At baseline, RHI averaged 2.39 ± 0.69 (mean ± standard deviation; n = 83), and over follow-up did not differ significantly among groups: oCEE, 2.26 ± 0.48 (n = 26); tE2, 2.26 ± 0.45 (n = 24); and placebo, 2.37 ± 0.37 (n = 33). Changes in RHI did not correlate with changes in traditional cardiovascular risk factors, but may inversely correlate with carotid intima medial thickness (Spearman correlation coefficient ρ = -0.268, p = 0.012).

Conclusion: In this 4-year prospective assessment of recently menopausal women, MHT did not significantly alter RHI when compared to placebo.

Show MeSH
Related in: MedlinePlus