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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 carotid intima-medial thickness (CIMT) over 4-year follow-up by average change in reactive hyperemia index (RHI). Each point represents an individual
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Figure 5: Changes in carotid intima-medial thickness (CIMT) over 4-year follow-up by average change in reactive hyperemia index (RHI). Each point represents an individual

Mentions: Consistent with the finding of no significant change in RHI over time, changes in RHI (averaged over follow-up) did not significantly correlate with changes in CVD risk factors nor with end-of-study estrogen levels (Table 3). However, there was a nominally significant inverse correlation between the change in RHI values and the change in CIMT relative to baseline (Spearman correlation coefficient ρ = −0.268, p = 0.012; Figure 5). There was no correlation with change in RHI values with changes in CAC scores. However, the change in average severity of night sweats (relative to baseline) had a nominally significant inverse correlation with change in average RHI (Spearman ρ = − 0.252, p = 0.016; Figure 6).


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 carotid intima-medial thickness (CIMT) over 4-year follow-up by average change in reactive hyperemia index (RHI). Each point represents an individual
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Changes in carotid intima-medial thickness (CIMT) over 4-year follow-up by average change in reactive hyperemia index (RHI). Each point represents an individual
Mentions: Consistent with the finding of no significant change in RHI over time, changes in RHI (averaged over follow-up) did not significantly correlate with changes in CVD risk factors nor with end-of-study estrogen levels (Table 3). However, there was a nominally significant inverse correlation between the change in RHI values and the change in CIMT relative to baseline (Spearman correlation coefficient ρ = −0.268, p = 0.012; Figure 5). There was no correlation with change in RHI values with changes in CAC scores. However, the change in average severity of night sweats (relative to baseline) had a nominally significant inverse correlation with change in average RHI (Spearman ρ = − 0.252, p = 0.016; Figure 6).

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