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Ann Intern Med. 1994 Dec 15;121(12):936-41.

Estrogen improves endothelium-dependent, flow-mediated vasodilation in postmenopausal women.

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1
Brigham and Women's Hospital, Boston, Massachusetts.

Abstract

OBJECTIVE:

To assess the effect of estrogen replacement therapy on endothelium-dependent vasodilation in postmenopausal women.

DESIGN:

Double-blind, placebo-controlled, crossover trial.

SETTING:

University medical center.

PATIENTS:

13 postmenopausal women aged 44 to 69 years (average age, 55 +/- 7 years).

INTERVENTION:

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.

MEASUREMENTS:

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.

RESULTS:

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.

CONCLUSION:

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.

[Indexed for MEDLINE]

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