Cardiovascular responses of perimenopausal women to hormonal replacement therapy

Kamali, P; Müller, Tanja; Lang, Uwe; Clapp, James F.

doi:10.1016/s0002-9378(00)70485-6

Cited by 25 publications

(14 citation statements)

References 20 publications

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Section: Discussionmentioning

confidence: 99%

“…It is of interest to note that the reported beneficial effects of hormone replacement therapy appear to be related to early "perimenopausal" treatments, and the effectiveness of this therapy significantly diminishes if it is not initiated until later in menopause. 20,21 Alternatively, the lessened responsiveness in older SHR may reflect an impairment of their estrogen response mechanisms, eg, reduced estrogen receptors.The results of this study suggest that the mechanisms that underlie NaCl-sensitive hypertension in female middle-aged SHR are, at least in some respects, similar to the mechanisms that underlie NaCl-sensitive hypertension in young male SHR. In young male SHR, the ability of a high NaCl diet to increase arterial pressure is dependent on the sympathetic nervous system.…”

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confidence: 99%

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Estrogen Depletion Increases Blood Pressure and Hypothalamic Norepinephrine in Middle-Aged Spontaneously Hypertensive Rats

et al. 2003

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Abstract-In male spontaneously hypertensive rats (SHR) a high NaCl diet increases arterial pressure via a reduction in anterior hypothalamic nucleus norepinephrine release. Young female SHR are relatively well protected from this NaCl-sensitive hypertension, but depletion of both endogenous and dietary estrogens greatly exacerbates NaCl-sensitive hypertension. This study tests the hypothesis that estrogen also protects late middle-aged female SHR from NaCl-sensitive hypertension and that this effect is mediated by an estrogen-related effect on hypothalamic norepinephrine release. Ten-month-old female SHR were ovariectomized and placed on a phytoestrogen-free diet containing either basal or high NaCl. Each rat was implanted with a silastic tube containing 17␤ estradiol or vehicle. Three months later, arterial pressure and hypothalamic norepinephrine metabolite levels (MOPEG) were measured. On the basal NaCl diet, estrogen-depleted rats displayed increased arterial pressure (12 mm Hg) and decreased anterior hypothalamic nucleus MOPEG (20%). Both effects were reversed by estrogen treatment. In all groups, the high NaCl diet increased arterial pressure by over 35 mm Hg and reduced anterior hypothalamic nucleus MOPEG by Ͼ60%. Across all groups, there was a significant inverse correlation between arterial pressure and anterior hypothalamic nucleus MOPEG. These data suggest that both dietary NaCl excess and estrogen depletion raise arterial pressure in middle-aged female SHR by a decreasing hypothalamic norepinephrine. Key Words: estrogen Ⅲ norepinephrine Ⅲ sodium Ⅲ sympathetic nervous system Ⅲ blood pressure H ypertension significantly contributes to premature death in the fastest-growing segment of the population, ie, adults over 65 years of age. 1 The incidence of hypertension in this age group is about 60%. [2][3][4] Further, between 30% and 50% of hypertensive patients are NaCl-sensitive, ie, they display a significant (Ͼ10%) increase in blood pressure when placed on a high NaCl diet (200 to 250 mEq Na ϩ /d for 7 days). The NaCl-sensitive hypertensive patients, in contrast to normotensive and NaCl-resistant hypertensive subjects, fail to suppress plasma norepinephrine (NE) after the ingestion of a diet high in NaCl. 5,6 These and other studies suggest that the sympathetic nervous system contributes importantly to NaCl-sensitive hypertension in aging humans. 7,8 Several lines of evidence indicate that, compared with men, premenopausal women have a lower rate of hypertension. After menopause this relative protection appears to be lost, and women experience a rapid rise in hypertension (including salt-sensitive hypertension). 9,10 This increase appears to be related to the menopausal loss of estrogen. Our studies in spontaneously hypertensive rats (SHR) demonstrate that young female SHR (compared with age-matched male SHR) have a lower arterial pressure and a reduced hypertensive response to excess dietary NaCl. 11 Elimination of most endogenous estrogen by ovariectomy causes no significant change in arterial pressur...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Estrogen Depletion Increases Blood Pressure and Hypothalamic Norepinephrine in Middle-Aged Spontaneously Hypertensive Rats

et al. 2003

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“…The vasculature, like the reproductive tissues is now recognized as an important target of estrogen's action [10]. Estrogen increases vasodilatation and inhibits the response of blood vessels to injury and the development of atherosclerosis through their direct or genomic-dependent activities that may potentiate cardiac diastolic and left ventricular function [11][12][13][14][15]. However, in a long-term study evaluating the effects of combined HRT on endothelial function demonstrated no improvement over placebo suggesting that HRT may not be of cardiovascular benefit in post-menopausal women [16].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of tibolone and estrogen replacement therapy on echocardiographic basic cardiac functions in post-menopausal women: a randomized placebo controlled study

et al. 2004

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“…Compared to nondiabetic women, diabetic women are more likely to have abnormal lipoprotein levels with higher triglycerides and low HDL cholesterol. (5,6) …”

Section: Diabetes Mellitusmentioning

confidence: 99%

“…Other effects of oestrogen include antioxidant property, restoration of normal endothelium, improved fibrinolysis, improved insulin sensitivity and lower Lp(a) level. (5,6,7) 1. Obesity worsens CAD risk factors including hypertension, diabetes and hypercholesterolaemia.…”

Section: Hypertensionmentioning

confidence: 99%

Coronary Artery Disease Risk Factors in Women- A Study on Serum Lipids and Lipoproteins

Nair¹,

Janardhanan²,

Pillai³

2017

jemds

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BACKGROUND Cardiovascular diseases are now the most common cause of death worldwide. Most of the risk factors for coronary artery disease were similar for both men and women, but some are unique to women. The present study was carried out to identify the presence of risk factors of CAD in a group of working women. MATERIALS AND METHODSA descriptive study was carried out in which distribution of serum lipids and other risk factors of CAD in 200 females of different age groups ranging from 20 to 60 years were assessed. The statistical analysis was performed using one-way ANOVA test and correlation study. RESULTSThe mean values for lipids are total cholesterol -184.88 ± 30.8, triglycerides -100.57 ± 38.42, LDL cholesterol -114.79 ± 32.64, HDL cholesterol -49.95 ± 10.5 and total cholesterol/HDL ratio -3.88. Comparison of the parameters in different age group shows the risk category is more in group 4, which include women in age group 46-60 yrs. CONCLUSIONThe analysis reveals that the level of total cholesterol, LDL cholesterol and triglycerides are higher in older age groups while HDL cholesterol levels are decreasing as age advances and that the women in postmenopausal age group has a more atherogenic lipid profile than premenopausal women. Those with other risk factors such as hypertension, diabetes mellitus and obesity have more atherogenic lipid profile. KEYWORDS BACKGROUNDCardiovascular disease is a major health problem in many countries. It is the leading cause of mortality in developed countries. Mortality from Coronary Artery Disease (CAD) begins later in women than in men occurring more often in postmenopausal women predominantly in their sixties and older. (1) Studies have shown a high prevalence of CAD in both urban and rural population of India. This increase in CAD rates is primarily due to the change in lifestyle, mostly the dietary changes.

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Cardiovascular responses of perimenopausal women to hormonal replacement therapy

Cited by 25 publications

References 20 publications

Estrogen Depletion Increases Blood Pressure and Hypothalamic Norepinephrine in Middle-Aged Spontaneously Hypertensive Rats

Estrogen Depletion Increases Blood Pressure and Hypothalamic Norepinephrine in Middle-Aged Spontaneously Hypertensive Rats

Comparison of the effects of tibolone and estrogen replacement therapy on echocardiographic basic cardiac functions in post-menopausal women: a randomized placebo controlled study

Coronary Artery Disease Risk Factors in Women- A Study on Serum Lipids and Lipoproteins

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