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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

Percentage of women with reactive hyperemia index (RHI) values in the high (RHI > 2), low (RHI < 1.7) and intermediate (RHI 1.7–2) ranges by treatment group over the 4 years of study. Transdermal, n = 24; Oral, n = 26; Placebo, n = 33. BL, baseline
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Figure 2: Percentage of women with reactive hyperemia index (RHI) values in the high (RHI > 2), low (RHI < 1.7) and intermediate (RHI 1.7–2) ranges by treatment group over the 4 years of study. Transdermal, n = 24; Oral, n = 26; Placebo, n = 33. BL, baseline

Mentions: Percentages of women with RHI values in the high (> 2.0), intermediate (1.7 < 2.0) and low ranges (< 1.7) are displayed in Figure 2 across study visits and by treatment group. A total of 41 (43%) women had at least one low (< 1.7) reading over the study period.


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)

Percentage of women with reactive hyperemia index (RHI) values in the high (RHI > 2), low (RHI < 1.7) and intermediate (RHI 1.7–2) ranges by treatment group over the 4 years of study. Transdermal, n = 24; Oral, n = 26; Placebo, n = 33. BL, baseline
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Percentage of women with reactive hyperemia index (RHI) values in the high (RHI > 2), low (RHI < 1.7) and intermediate (RHI 1.7–2) ranges by treatment group over the 4 years of study. Transdermal, n = 24; Oral, n = 26; Placebo, n = 33. BL, baseline
Mentions: Percentages of women with RHI values in the high (> 2.0), intermediate (1.7 < 2.0) and low ranges (< 1.7) are displayed in Figure 2 across study visits and by treatment group. A total of 41 (43%) women had at least one low (< 1.7) reading over the study period.

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