Estrogen Improves Endothelium-Dependent, Flow-Mediated Vasodilation in Postmenopausal Women

  1. Eric H. Lieberman, MD;
  2. Marie D. Gerhard, MD;
  3. Akimi Uehata, MD;
  4. Brian W. Walsh, MD;
  5. Andrew P. Selwyn, MD;
  6. Peter Ganz, MD;
  7. Alan C. Yeung, MD; and
  8. Mark A. Creager, MD
  1. From Brigham and Women's Hospital, Boston, Massachusetts; Mt. Sinai Hospital, Miami, Florida; National Defence Medical College, Tokorozawa, Saitama, Japan; and Stanford University Medical Center, Stanford, California. Requests for Reprints: Mark A. Creager, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. Grant Support: By the National Heart, Lung, and Blood Institute (grants HL02663, HL38780, and HL02566).

    Abstract

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

    Design: Double-blind, placebo-controlled, cross-over 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.

    « Previous | Next Article »Table of Contents

    This Article

    1. Ann Intern Med December 15, 1994 vol. 121 no. 12 936-941
    1. » Abstract
    2. Figures
    3. Full Text
    4. Full Text (PDF)

    Rapid Responses

    1. Submit a response
    2. No responses published

    Current Issue

    1. November 17, 2009, 151 (10)
    1. Alert me to current issues