Eric H. Lieberman, MD; Marie D. Gerhard, MD; Akimi Uehata, MD; Brian W. Walsh, MD; Andrew P. Selwyn, MD; Peter Ganz, MD; Alan C. Yeung, MD; Mark A. Creager, MD
To assess the effect of estrogen replacement therapy on endothelium-dependent vasodilation in postmenopausal women.
Double-blind, placebo-controlled, cross-over trial.
University medical center.
13 postmenopausal women aged 44 to 69 years (average age, 55 ±7 years).
Patients were randomly assigned to receive placebo, oral estradiol at a dose of 1 mg/d, and oral estradiol at a dose of 2 mg/d. Each treatment phase lasted 9 weeks.
High-resolution ultrasonography was used to measure vascular reactivity in a peripheral conduit vessel, the brachial artery. Endothelium-dependent vasodilation was determined by measuring the change in brachial artery diameter during increases in flow induced by reactive hyperemia. Endothelium-independent vasodilation was measured after sublingual nitroglycerin was administered.
Flow-mediated, endothelium-dependent vasodilation of the brachial artery was greater when patients received estradiol (13.5% and 11.6% for 1-mg and 2-mg doses, respectively) than when patients received placebo (6.8%; P < 0.05 for each dose compared with placebo). In contrast, estrogen administration had no effect on endothelium-independent vasodilation as assessed by sublingual nitroglycerin.
Short-term estrogen replacement therapy improves flow-mediated endothelium-dependent vasodilation in postmenopausal women. This improvement may be mediated by a direct effect of estrogen on vascular function or may be induced through modification of lipoprotein metabolism.
Lieberman EH, Gerhard MD, Uehata A, Walsh BW, Selwyn AP, Ganz P, et al. Estrogen Improves Endothelium-Dependent, Flow-Mediated Vasodilation in Postmenopausal Women. Ann Intern Med. ;121:936–941. doi: 10.7326/0003-4819-121-12-199412150-00005
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Published: Ann Intern Med. 1994;121(12):936-941.
Cardiology, Coronary Risk Factors, Dyslipidemia.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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