Influence of age and postmenopausal estrogen replacement therapy on carotid arterial stiffness in women.

OBJECTIVE: This study examines the influence of age and current estrogen replacement therapy (ERT) on common carotid arterial (CCA) stiffness in women. METHODS: The subjects comprised 172 women (age 55.6 +/- 16.4 years) from the Baltimore Longitudinal Study of Aging, including 37 current postmenopausal ERT users. The ERT users included 18 women taking estrogen alone and 19 women taking estrogen and progesterone. Bilateral CCA were examined by B-mode carotid ultrasonography, and the stiffness index was defined as the logarithm of the ratio of systolic to diastolic blood pressure (BP) divided by the fractional diameter increase during the cardiac cycle. RESULTS: The stiffness index increased linearly with age (r = 0.69, p < 0.001), and was lower in ERT users than in postmenopausal nonusers (8.0 +/- 2.0 vs 9.7 +/- 3.1, p < 0.01). Furthermore, the effects of age (beta = 0.67, p < 0.0001) and ERT (beta = -0.23, p < 0.001) on the stiffness index persisted after adjustments for systolic BP (beta = 0.23, p < 0.01), diastolic BP (beta = -0.26, p < 0.001) and other cardiovascular risk factors (model r2 = 0.59, p < 0.0001). The stiffness index was similar in both ERT users with and without progesterone and lower than in postmenopausal nonusers (p < 0.05) after considering the age effects. CONCLUSION: Age-associated increases in CCA stiffness are reduced by postmenopausal ERT.

A prospective study of estrogen replacement therapy and the risk of developing Alzheimer's disease: the Baltimore Longitudinal Study of Aging.

Previous reports have suggested that estrogen replacement therapy (ERT) in women may exert a protective effect on their risk of developing Alzheimer's disease (AD). We investigated this relationship in the Baltimore Longitudinal Study of Aging (BLSA), a prospective multidisciplinary study of normal aging conducted by the National Institute on Aging. The sample consisted of 472 post- or perimenopausal women followed for up to 16 years in the BLSA. We documented ERT prospectively at each BLSA visit, and we categorized women who had used oral or transdermal estrogens at anytime as ERT users. We used Cox proportional hazards models with time-dependent covariates to estimate the relative risk of developing AD after ERT as compared with women who had not used estrogen replacement. Approximately 45% of the women in the cohort had used ERT, and we diagnosed 34 incident cases of AD (NINCDS/ADRDA criteria) during follow-up, including nine estrogen users. After adjusting for education, the relative risk for AD in ERT users as compared with nonusers was 0.46 (95% CI, 0.209-0.997), indicating a reduced risk of AD for women who had reported the use of estrogen. Our data did not show an effect for duration of ERT usage. Our finding offers additional support for a protective influence of estrogen in AD. Randomized clinical trials are necessary to confirm this association, which could have significant public health impact.

Effects of estrogen status and aging on salivary flow rates in healthy Caucasian women.

A comparison of salivary flow rates was made between three groups of female individuals according to their menopausal status. The three groups consisted of healthy, dentate, nonmedicated women (with the exception of the use of estrogen) from the Baltimore Longitudinal Study of Aging. One group consisted of premenopausal women (n = 51), their mean age was 39 years. Another group (n = 26) was perimenopausal with a mean age of 48 years. A third group (n = 76) was postmenopausal with a mean age of 69 years. The groups were evaluated for unstimulated (UPAR) and stimulated parotid gland flow rates (SPAR), unstimulated (USUB) and stimulated submandibular/sublingual gland flow rates (SSUB), and stimulated whole-saliva flow rates (SWHOLE). The parotid flow rates were determined using a Carlson-Crittenden cup, while the submandibular/sublingual flow rates were determined using the National Institute of Dental Research collector. A 2% citrate solution was used for stimulation in glandular collections. Chewing a 1-cm3 cube of paraffin was used to stimulate whole saliva. The results showed no significant differences in UPAR, SPAR, and SWHOLE between the three groups. However, the premenopausal women had higher USUB than the postmenopausal group. The premenopausal women also had higher SSUB than perimenopausal and postmenopausal groups. There were no differences in salivary flow rates between those taking estrogen and those that were not medicated.