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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

Change in reactive hyperemia index (RHI) values from baseline in each treatment group over the course of the study. In order to reduce the effect of variability, an average RHI value was calculated for each woman for those years for which there were follow-up measurements and those were averaged for each year. Data are shown as the mean ± standard deviation for the change within each time point by treatment group
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Figure 3: Change in reactive hyperemia index (RHI) values from baseline in each treatment group over the course of the study. In order to reduce the effect of variability, an average RHI value was calculated for each woman for those years for which there were follow-up measurements and those were averaged for each year. Data are shown as the mean ± standard deviation for the change within each time point by treatment group

Mentions: The time trend of these RHI categories did not differ significantly across the three treatment groups, neither with time defined on a linear scale (p = 0.075) or as a contrast between baseline and all follow-up levels pooled together (p = 0.74). Likewise, when analyzing serially measured RHI as values instead of categories, the response over time was not significantly different across treatment groups (linear time, p = 0.56; contrast of baseline vs. follow-up time, p = 0.90; Table 2 and Figure 3).


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)

Change in reactive hyperemia index (RHI) values from baseline in each treatment group over the course of the study. In order to reduce the effect of variability, an average RHI value was calculated for each woman for those years for which there were follow-up measurements and those were averaged for each year. Data are shown as the mean ± standard deviation for the change within each time point by treatment group
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Change in reactive hyperemia index (RHI) values from baseline in each treatment group over the course of the study. In order to reduce the effect of variability, an average RHI value was calculated for each woman for those years for which there were follow-up measurements and those were averaged for each year. Data are shown as the mean ± standard deviation for the change within each time point by treatment group
Mentions: The time trend of these RHI categories did not differ significantly across the three treatment groups, neither with time defined on a linear scale (p = 0.075) or as a contrast between baseline and all follow-up levels pooled together (p = 0.74). Likewise, when analyzing serially measured RHI as values instead of categories, the response over time was not significantly different across treatment groups (linear time, p = 0.56; contrast of baseline vs. follow-up time, p = 0.90; Table 2 and Figure 3).

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