Effect of Long-term Hormone Replacement Therapy on Coronary Endothelial Function in Postmenopausal Women

Halligan, Sean; Murtagh, Blaithnead; Lennon, Ryan J.; Pumper, Geralyn M.; Mathew, Verghese; Higano, Stuart T.; Lerman, Amir

doi:10.4065/79.12.1514

Cited by 24 publications

(25 citation statements)

References 32 publications

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“…These results are consistent with the concept that estrogen has no effect on adenosine in postmenopausal women. 14,15 Although plasma adenosine decreased following HRT in the peri-menopausal women, the current results suggest that the increased plasma adenosine in climacteric women is not associated with decreased estrogen but with the symptom of hot flushes.…”

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

“…14,15 Moreover, HRT status has not shown any association with improvement in coronary circulation in postmenopausal women. 14 The postmenopausal state has been reported to be associated with a greater abnormality in endothelial function at the level of the microcirculation. 14 In addition, a hypothesis that other factors, such as age, may contribute more to endothelial dysfunction than hormone status has been discussed in relation to postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

“…14 The postmenopausal state has been reported to be associated with a greater abnormality in endothelial function at the level of the microcirculation. 14 In addition, a hypothesis that other factors, such as age, may contribute more to endothelial dysfunction than hormone status has been discussed in relation to postmenopausal women. The net result may indicate a diminished or lost adenosine response despite continued circulatory dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…8 In earlier studies of patients with chronic heart failure, elevation of plasma adenosine levels was observed and thought to attenuate the cardiovascular effect of norepinephrine. [9][10][11][12][13] Although some earlier studies have denied the effect of estrogen on adenosine as a primary endothelium-independent vasodilator in postmenopausal women, 14,15 changes in plasma adenosine levels in peri-menopausal women with hot flushes have not previously been examined. In this study, we measured plasma adenosine levels and observed the effect of hormone (estrogen) replacement therapy (HRT) on the adenosine level in peri-menopausal women experiencing hot flushes.…”

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confidence: 99%

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Plasma Adenosine Levels in Peri-Menopausal Women Having Frequent Hot Flushes

Suzuki

Takeuchi

2005

Circ J

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enopause is associated with an increased risk of cardiovascular disease. Several protective actions of estrogen, including peripheral vasodilation, have been described, 1,2 but the mechanisms underlying these effects remain unclear. Increased adrenergic activity and/or higher cardiovascular responsiveness have been reported to occur in peri-and postmenopausal women, 3,4 although not all authors concur with this finding. 5 For example, Komesaroff et al observed that estrogen supplementation attenuates blood pressure, glucocorticoid, and catecholamine responses to psychological stress in perimenopausal women. 6 Hot flushes, one of the most common and earlier symptoms of the climacteric (peri-menopausal) syndrome, are characteristic sudden sensations of intense heat with sweating and flushing, but these episodes typically disappear after 1-5 years in the vast majority of postmenopausal women. 7 Hot flushes have also been reported to be associated with endocrine changes such as increased catecholamine production in the brain. 7 Adenosine is a vasoactive purine metabolite that is a potent vasodilator in many organs and a metabolic regulator in the cardiovascular system. 8 In earlier studies of patients with chronic heart failure, elevation of plasma adenosine levels was observed and thought to attenuate the cardiovascular effect of norepinephrine. 9-13 Although some earlier studies have denied the effect of estrogen on adenosine as a primary endothelium-independent vasodilator in postmenopausal women, 14,15 changes in plasma adenosine levels in peri-menopausal women with hot flushes have not previously been examined. In this study, we measured plasma adenosine levels and observed the effect of hormone (estrogen) replacement therapy (HRT) on the adenosine level in peri-menopausal women experiencing hot flushes. MethodsIn accordance with hospital policies on human research, informed consent was obtained from all subjects prior to the study. Between April 2002 and March 2005, we obtained 8.0 ml samples of blood from 32 outpatients whose chief compliant was hot flushes and 29 healthy female volunteers who came to the hospital for cancer screening. Using these samples, we measured serum estradiol (E2) and folliculestimulating hormone (FSH) levels by radioimmunoassay with commercially available kits according to the manufacturer's instructions. Peri-menopause was defined as the presence of hot flushes with serum E2 <30 pg/ml and FSH ≥40 mIU/ml. In this study, peri-menopausal women with hot flushes were divided into 2 groups: >5 times per day was defined as frequent hot flushes (n=13); <1 or 2 times per day was defined as few hot flushes (n=9). Thirteen perimenopausal patients with frequent hot flushes (average age, 48.1±2.0 (range: 44-52) years old, frequent hot flushes group) received 28-day cycle HRT: oral conjugated equine estrogens 0.625 mg/day (Premarin) from days 5 to 18, a combination of Premarin with 2.5 mg/day continuous medroxyprogesterone acetate (Provera) from days 19 to 25 then a 7-day drug withdrawal. Before ...

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Plasma Adenosine Levels in Peri-Menopausal Women Having Frequent Hot Flushes

Suzuki

Takeuchi

2005

Circ J

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Comparing EndoPAT and BIOPAC measurement of vascular responses to mental stress

Martin

Nelson

Felmlee-Devine

et al. 2011

Cell Biochemistry & Function

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There are currently no comparison measurements of stress-induced changes in vascular function during acute mental stress tests to measurements made by BIOPAC MP150 systems technology, a standard polygraph device used to detect deception during polygraph examinations in military or law enforcement applications. Vascular responses to reactive hyperaemia and acute mental stress in 25 healthy subjects were measured by both peripheral arterial tonometry (EndoPAT) and a blood pressure cuff attached to a pressure transducer (BIOPAC) and compared. Reactive hyperaemia was performed at baseline and following three acute mental stress tests. There was no difference in vascular reactivity at baseline and following acute mental stress, as measured by EndoPAT or BIOPAC systems (p > 0·05). Mental stress ratios measured by EndoPAT were significantly different than those measured by BIOPAC (p < 0·01). These data suggest that EndoPAT measurements of vascular responses to acute mental stress may be more specific and sensitive than measurements using the BIOPAC system.

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