Effect of hormone replacement therapy on non-invasive cardiovascular haemodynamics.
J Hypertens
; 15(9): 987-93, 1997 Sep.
Article
em En
| MEDLINE
| ID: mdl-9321746
ABSTRACT
OBJECTIVE:
To determine the detailed effects of hormone replacement therapy (HRT) on non-invasive haemodynamics, including an assessment of the effect on the pulsatile afterload assessed in terms of the augmentation index and pulse-wave velocity.DESIGN:
A cross-sectional study of healthy postmenopausal women using carotid and radial tonometry and pulse-wave velocity measurements.SETTING:
Community-based ambulatory women attending the menopause centre at a tertiary hospital. PATIENTS Seventy postmenopausal women divided into those not currently being administered HRT (n = 38, aged 46-72 years) and those who were being administered a variety of HRT (n = 32, aged 49-67 years).METHODS:
Central arterial pressure waveforms were measured using carotid applanation tonometry to derive the augmentation index and ejection duration. The arterial pulse-wave velocity was assessed using paired carotid, radial and dorsalis tonometry waveforms.RESULTS:
Women being administered HRT had a significantly lower augmentation index (20.4 +/- 8.6 versus 27.0 +/- 10.2%, P = 0.005) and shorter ejection times (320 +/- 17 versus 329 +/- 18 ms, P = 0.037). There was no significant difference in brachial blood pressure (131/76 versus 129/77 mmHg). Women being administered HRT exhibited a greater reversal in the age-related loss of amplification which occurs owing to arterial stiffening. This amplification between central and peripheral systolic blood pressures was greater among women being administered HRT (5.3 +/- 6.2 versus 2.2 +/- 4.0 mmHg, P = 0.014). There was no difference in pulse-wave velocity between the two groups.CONCLUSIONS:
HRT appears to improve the pulsatile vascular afterload by decreasing the augmentation of the late systolic blood pressure. This effect is not apparent from routine brachial cuff measurements, which, as a result, may underestimate haemodynamic benefits. Such effects may help to explain a portion of the improvement in cardiovascular morbidity found in other trials.
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Base de dados:
MEDLINE
Assunto principal:
Progesterona
/
Terapia de Reposição de Estrogênios
/
Estrogênios
/
Hemodinâmica
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
1997
Tipo de documento:
Article