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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

Changes in menopausal symptom scores by self-report. Decreases in scores represent decrease in severity of symptoms. Data are shown as mean ± standard deviation of change in symptom score at each time point from baseline. n = 33, 24, and 26 for placebo, transdermal and oral treatments, respectively
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Figure 4: Changes in menopausal symptom scores by self-report. Decreases in scores represent decrease in severity of symptoms. Data are shown as mean ± standard deviation of change in symptom score at each time point from baseline. n = 33, 24, and 26 for placebo, transdermal and oral treatments, respectively

Mentions: Changes in the aggregate menopausal symptom scores were different among groups (p = 0.004). Reductions in self-reported severity of hot flushes (p < 0.001) and night sweats (p = 0.002) were significantly greater in the two treatment groups compared to the placebo group (Figure 4).


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)

Changes in menopausal symptom scores by self-report. Decreases in scores represent decrease in severity of symptoms. Data are shown as mean ± standard deviation of change in symptom score at each time point from baseline. n = 33, 24, and 26 for placebo, transdermal and oral treatments, respectively
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Changes in menopausal symptom scores by self-report. Decreases in scores represent decrease in severity of symptoms. Data are shown as mean ± standard deviation of change in symptom score at each time point from baseline. n = 33, 24, and 26 for placebo, transdermal and oral treatments, respectively
Mentions: Changes in the aggregate menopausal symptom scores were different among groups (p = 0.004). Reductions in self-reported severity of hot flushes (p < 0.001) and night sweats (p = 0.002) were significantly greater in the two treatment groups compared to the placebo group (Figure 4).

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