van Ittersum FJ, van Baal WM, Mijatovic V, Donker AJM,
Kenemans P, Stehouwer CDA
Ambulatory blood pressures, not office blood pressure, decline
during estrogen replacement therapy in postmenopausal women
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:147A 1997
The cardiovascular protective effects of estrogen replacement therapy
on postmenopausal women has been previously studied by several
investigators. The effect on blood pressure has been evaluated but
with variable results which may stem from patient selection, criteria
for defining postmenopausal, and methods for measuring blood pressure.
This current study used ambulatory blood pressure to evaluate the
effects of estrogen replacement on blood pressure.
29 healthy females mean age 52.3 years with a median duration of
menopause of 34.5 months were randomized to two groups the replacement
group who received 17B-oestradiol 2 mg once daily every day and 5 or
10 mg dihydrogesterone once daily the third and fourth week of every
four weeks and a control group. The follow-up period was one year.
Office blood pressure did not change significantly in either group.
Both ambulatory systolic and diastolic blood pressures declined
significantly in the estrogen replacement groups during treatment
(before treatment 117.1(9.2)/74.4 (6.6) mmHg, after 1 year of
treatment 112.3(7.9)/70.5(5.7). In the control group there was an
increase in pressures during the study period (baseline
113.8(11.2)/71.3(7.4) and after one year 117.5(10.1)/72.5(7.2).
Changes from baseline of mean 24 hour blood pressure differed
significantly between the control group and treated group.
Comment: The authors cautiously concluded that the blood
pressure changes in the replacement groups were different from the
controls and that estrogen replacement might have blood pressure
lowering effects. As pointed out by the authors the study population
is small. There is no note as to whether the treatment was blinded.
It would be interesting to see if there was a difference in day or
night blood pressure and not just the mean 24 hour value. (Betsy
Ripley, M.D., Medical College of Virginia)
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12th Annual ASH Meeting
H: Special problems :
Women
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Ambulatory monitoring