Endothelial-mediated microcirculatory responses to an acute estradiol test are influenced by time since menopause, cumulative hormone exposure, and vasomotor symptoms

Abstract

Changes in RBCVs and TRBCVmax after estradiol administration indicate an increase in endothelial-dependent vasodilatation and vascular elasticity, respectively. Moreover, maintenance of endothelial responsiveness depends on cumulative exposure to sex steroids, duration of hormone deprivation, and triglyceride levels. Past smoking and current vasomotor symptoms could be associated to microvascular wall stiffness/elasticity.

Early postmenopausal women with cardiovascular risk factors improve microvascular dysfunction after acute estradiol administration

“…40 Hot flashes are currently being investigated as potential CV risk hallmarks. Different from our previous study on healthy 34-to 70-year-old PMW in which TRBCV max reduction after estradiol was impaired according to hot flash intensity, 3 we did not find a significant influence of hot flashes on NVC parameters in these symptomatic early postmenopausal HD and C groups.…”

“…Nevertheless, surgical menopause, by occurring at a younger age than natural menopause, would favor better endothelial function, as shown previously. 3 As expected, at baseline, HD PMW displayed lower microcirculatory flow (RBCV) and borderline lower reactivity FIG. 3.…”

“…Our group has recently demonstrated that in healthy 34-to 70-year-old postmenopausal women (PMW), vasodilation after acute estradiol administrationVsignaling endothelial NO productionVwas dependent on time since menopause (TSM) and cumulative hormonal exposure. 3 However, current triglyceride levels and past smoking impaired vasodilation and vascular wall elasticity, respectively, supporting that early onset of hormone therapy (HT), together with metabolic control and lifestyle measures, may be key issues in postmenopausal endothelial function maintenance and potential CV risk reduction in otherwise healthy women.…”

“…As in our previous studies, 3,12 we have used functional nailfold videocapillaroscopy (NVC), a simple, quick, noninvasive, low-cost technique derived from capillaroscopy, created in 1977 13 and originally used in rheumatological and dermatological studies. NVC is available in most centers, and its use has expanded to other situations, 14 being especially suitable for the study of endothelial function because capillaries, microvessels with only endothelial layer, can be directly visualized through a microscope, and red blood cell velocity (RBCV), as the cells pass through them, could be used to quantify blood flow and tissue perfusion.…”

In elderly women moderate hypercholesterolemia is associated to endothelial and microcirculatory impairments

“…Although mostly in the normal range, triglyceride levels in our elderly patients influenced negatively the percent blood flow increase from reactive hyperemia during plethysmography. The same happened in a previous study in healthy postmenopausal women, where normal triglyceride levels were shown to be negatively associated with RBCV and RBCV max increases after estradiol (Clapauch et al, 2010). In contrast, transient hypertriglyceridemia was shown to decrease brachial artery FMD from 7.1± 3.0% to 1.6± 2.6% in healthy young volunteers (Lundman et al, 1997).…”