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, et al. Estrogen Improves Endothelium-Dependent, Flow-Mediated Vasodilation in Postmenopausal Women. Ann Intern Med. 1994;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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