The effects of different hormone treatment on endothelial function in healthy postmenopausal women

Abstract Background The arterial effects of hormone therapy remain controversial. This study tested the effects of transdermal estradiol plus intermittent micronized progesterone (TE + IMP) in healthy perimenopausal and early postmenopausal women on several mechanisms involved in the pathophysiology of arterial disease. Methods Healthy perimenopausal and early postmenopausal women, ages 45 to 60 years, were enrolled in this randomized, double-blind, placebo-controlled trial. Women were randomized to receive TE (0.1 mg/day) + IMP (200 mg/day for 12 days) or identical placebo patches and pills for 12 months. Outcomes included: change in stress reactivity composite z-score (combining inflammatory, cortisol, and hemodynamic responses to a standardized psychological laboratory stressor); flow-mediated dilation (FMD) of the brachial artery (an index of vascular endothelial function); baroreflex sensitivity; and metabolic risk (presence of the metabolic syndrome or insulin resistance), all assessed at baseline and at months 6 and 12. Results Of 172 women enrolled, those assigned to TE + IMP tended to have higher resting baroreflex sensitivity than those assigned to placebo across the 6- and 12-month visits. Although treatment groups did not differ in terms of the other prespecified outcomes, a significant treatment-by-age interaction was found for FMD and stress reactivity such that an age-related decrease in FMD and increase in stress reactivity were seen among women assigned to placebo but not those assigned to TE + IMP. Women on TE + IMP also had lower resting diastolic blood pressure, lower levels of low-density lipoprotein cholesterol, and higher baroreflex sensitivity during stress testing. Conclusions TE + IMP tended to improve cardiac autonomic control and prevented age-related changes in stress reactivity and endothelial function among healthy perimenopausal and early postmenopausal women.

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Effectiveness of the short-term use of Cimicifuga racemosa in the endothelial function of postmenopausal women: a double-blind, randomized, controlled trial

Climacteric ◽

10.1080/13697137.2019.1682542 ◽

2019 ◽

Vol 23 (3) ◽

pp. 245-251

Author(s):

E. S. Fernandes ◽

M. F. S. Celani ◽

M. Fistarol ◽

S. Geber

Keyword(s):

Randomized Controlled Trial ◽

Endothelial Function ◽

Postmenopausal Women ◽

Controlled Trial ◽

Cimicifuga Racemosa ◽

Short Term ◽

Double Blind ◽

Randomized Controlled

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Effects of resveratrol or estradiol on postexercise endothelial function in estrogen-deficient postmenopausal women

Journal of Applied Physiology ◽

10.1152/japplphysiol.00488.2019 ◽

2020 ◽

Vol 128 (4) ◽

pp. 739-747

Author(s):

Cemal Ozemek ◽

Kerry L. Hildreth ◽

Patrick J. Blatchford ◽

K. Joseph Hurt ◽

Rachael Bok ◽

...

Keyword(s):

Exercise Training ◽

Endothelial Function ◽

Aerobic Exercise ◽

Postmenopausal Women ◽

Endurance Exercise ◽

Acute Exercise ◽

Aerobic Exercise Training ◽

Moderate Intensity ◽

Training Effects ◽

Estradiol Treatment

Regular exercise enhances endothelial function in older men, but not consistently in estrogen-deficient postmenopausal women. Estradiol treatment improves basal endothelial function and restores improvements in endothelial function (flow-mediated dilation, FMD) to aerobic exercise training in postmenopausal women; however, estradiol treatment is controversial. Resveratrol, an estrogen receptor ligand, enhances exercise training effects on cardiovascular function and nitric oxide (NO) release in animal models, but impairs exercise training effects in men. We conducted a randomized cross-over, double-blinded, placebo-controlled pilot study to determine whether acute (single dose) resveratrol (250-mg tablet) or estradiol (0.05 mg/day transdermal patch) treatment enhances FMD at rest and after a single bout of moderate-intensity aerobic exercise in healthy estrogen-deficient postmenopausal women ( n = 15, 58.1 ± 3.2 yr). FMD was measured before and after (30, 60, and 120 min) a 40-min bout of moderate-intensity treadmill exercise (60–75% peak heart rate) under the respective conditions (separated by 1-2 wk). FMD was higher ( P < 0.05) before exercise and at all post-exercise time points in the resveratrol and estradiol conditions compared to placebo. FMD was increased from baseline by 120 min postexercise in the estradiol condition ( P < 0.001), but not resveratrol or PL conditions. Consistent with our previous findings, estradiol also enhances endothelial function in response to acute endurance exercise. Although resveratrol improved basal FMD, there was no apparent enhancement of FMD to acute exercise and, therefore, may not act as an estradiol mimetic. NEW & NOTEWORTHY The benefits of endurance exercise training on endothelial function are diminished in estrogen-deficient postmenopausal women, but estradiol treatment appears to restore improvements in endothelial function in this group. We show that basal endothelial function is enhanced with both acute estradiol and resveratrol treatments in estrogen-deficient postmenopausal women, but endothelial function is only enhanced following acute endurance exercise with estradiol treatment.

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Tumor necrosis factor-α inhibition improves endothelial function and decreases arterial stiffness in estrogen-deficient postmenopausal women

Atherosclerosis ◽

10.1016/j.atherosclerosis.2013.07.057 ◽

2013 ◽

Vol 230 (2) ◽

pp. 390-396 ◽

Cited By ~ 35

Author(s):

Kerrie L. Moreau ◽

Kevin D. Deane ◽

Amie L. Meditz ◽

Wendy M. Kohrt

Keyword(s):

Tumor Necrosis Factor ◽

Arterial Stiffness ◽

Endothelial Function ◽

Postmenopausal Women ◽

Tumor Necrosis ◽

Tumor Necrosis Factor Α ◽

Factor Α ◽

Necrosis Factor

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Effects of antihypertensive treatment on endothelial function in postmenopausal hypertensive women. A significant role for aldosterone inhibition

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320311415134 ◽

2011 ◽

Vol 12 (4) ◽

pp. 446-455 ◽

Cited By ~ 6

Author(s):

Rosario Rossi ◽

Annachiara Nuzzo ◽

Daniele Iaccarino ◽

Antonella Lattanzi ◽

Giorgia Origliani ◽

...

Keyword(s):

Blood Pressure ◽

Optimal Control ◽

Endothelial Function ◽

Postmenopausal Women ◽

Antihypertensive Therapy ◽

Antihypertensive Treatment ◽

Pressure Control ◽

Ultrasound Study ◽

Optimal Blood Pressure

Introduction: Endothelial dysfunction is a well-demonstrated independent predictor of cardiovascular events in hypertensive postmenopausal women. Accordingly, it is plausible that improving endothelial function could represent an adjunctive target for antihypertensive treatment. The aim of our study was to evaluate the effect of pharmacologic treatment on endothelial function in the specific population of hypertensive postmenopausal women. Methods: A total of 320 consecutive hypertensive postmenopausal women underwent a high-resolution ultrasound study of the brachial artery at baseline and after six months, while ‘optimal’ control of blood pressure (maintenance of blood pressure values below 140/90 mmHg at all follow-up visits) was achieved using antihypertensive therapy. Endothelial function was measured as flow-mediated dilation, using ultrasound method. Results: After six months of treatment, flow-mediated dilatation (FMD) had significantly improved in the majority of patients (n = 257 [80.3% of the entire population]; FMD = 8.1 ± 1.0% at baseline vs. 10.6 ± 1.5% after follow-up; p < 0.001), but it had not changed or worsened in others (n = 63 [19.7%]; FMD = 8.2 ± 1.2% at baseline vs. 7.6 ± 1.0% after six months; p = ns). Improvement of endothelial function, at multivariate analysis, resulted independently associated with the use of aldosterone inhibitors (odds ratio = 2.15; 95% confidence interval: 1.55–2.75; p = 0.001). Conclusions: This study demonstrates that a significant improvement in endothelial function may be obtained after six months of an optimal antihypertensive therapy. Among all hypertensive postmenopausal women that achieved an optimal control of blood pressure during follow-up, the use of drugs that inhibit aldosterone receptors was associated with an improvement of endothelial function, beyond the ‘optimal’ blood pressure control.

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