Hemorheological aspects in hypertensive menopausal smoker women treated with female hormones.

In postmenopausal hypertensive women (PostMHW) the erythrocyte deformability (ED) is reduced if compared with premenopausal hypertensive women (PreMHW). This might partially explain the increased incidence of cardiovascular diseases (CD) in hypertensive women after menopause. Moreover a positive correlation exists between estradiol and rheological patterns in women. If PostMHW smoke cigarettes, there is an important decrease in hemorheological parameters. On the other hand if PostMHW are submitted to an hormonal replacement therapy (HRT) they can show controversial results with an impairment if hemorheological parameters. The aim of this study was to evaluate the influence of smoking and HRT on PostMHW. We studied four groups of subjects: Group 1: PreMHW (10 F aged 35 +/- 3 years) non smokers; Group 2: PostMHW (8 F aged 45 +/- 2 years) non smokers; Group 3: PostMHW (14 F aged 48 +/- 4 years) smokers (20 cigarettes per day); Group 4: PostMHW (16 F aged 50 +/- 2 years) smokers (20 cigarettes per day) submitted to HRT. We evaluated Elongation Index of erythrocytes under torsion force of 30 pascals (EI--30 Pa) using a new computerized instrument Laser assisted Optical rotational Red Cell Analyzer (LORCA) (Mechatronics, Hoorn, NL) acc. to Hardeman (1994) and, also with the same LORCA, Aggregation Index (AI), t(1/2). We measured the transcutaneous oxygen partial pressure (TcpO2) in subclavicular standard area using a Transcutaneous Oximeter (Microgas 7650 Kontron Instruments with Combi Sensor) and total cholesterolaemia. In PostMHW our data showed a significant (p < 0.01) impairment of hemorheological patterns and tissue oxygenation if compared with PreMHW (Group 1). In Group 3 there is a significant (p < 0.01) decrease in EI, a significant (p < 0.01) increase in AI, a significant (p < 0.01) decrease in t(1/2) and TcpO2 if compared with Control Group 1 and Group 2. Finally a further significant (p < 0.01) impairment in hemorheology and tissue oxygenation showed Group 4. In conclusion, it seems necessary, that many studies will be performed to understand really protective action of HRT on cardiovascular diseases in PostMHW and it is necessary to suppress cigarette smoking to prevent cardiovascular complications in these patients.

Hemorheology and tissue oxygenation in hypertensives with lipoidoproteinosis and peripheral occlusive arterial disease (POAD) treated with sulodexide and pravastatine and evaluated with laser assisted optical rotational red cell analyzer (LORCA) and transcutaneous oxymetry.

BACKGROUND: During arterial hypertension it is often possible to find other factors like lipoidoproteinosis and peripheral arterial disease (POAD), which can accentuate blood rheological abnormalities in hypertensive subjects. A group of hypertensives with lipoidoproteinosis (LP) and POAD were therefore examined to evaluate the relationship between these factors and blood rheological disorders and, if possible, to correct it. METHODS: We studied a group of 27 hypertensives with LP and POAD (15 males and 12 females in menopause for at least 1 year, aged 48 +/- 4 years), with WHO stage I hypertension, obesity (BMI = 30 +/- 2), stage II type "a" POAD, class 2 type "b" lipoidoproteinosis (acc. to Fredrick-son's classification) and hyperfibrinogenemia. All patients received oral medication with 500 lipidic units (ULS) sulodexide a day, 20 mg pravastatin o.d. orally, and were put on a low-salt and low-calorie diet (1400 kcal/day) during a follow-up of 60 days. Blood rheology status was evaluated before and after treatment (red blood cell--RBC--deformability and aggregability) using a new computerized instrument, which uses laser rays: the laser assisted optical rotational red cell analyzer (LORCA) (acc. to Hardeman) and RBC deformability using optical microscopy under immersion (acc. to Zipursky and Forconi). Transcutaneous oxymetry was also used to evaluate tissue oxygenation. RESULTS AND CONCLUSIONS: At the end of the study a significant improvement (p < 0.01) was noted in the blood rheological patterns of peripheral perfusion and tissue oxygenation. This underlined the positive influence of sulodexide with pravastatin in improving hemorheological patterns and modulating hypercholesterolemia and hyperfibrogenemia in hypertensives with POAD II "a" and LP 2 "b" and blood rheology disorders.