on May 31, 2007
Published online before print May 31, 2007, doi: 10.1161/ATVBAHA.107.145383
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Submitted on July 7, 2006
Accepted on May 7, 2007
Age Moderates the Short-Term Effects of Transdermal 17
-Estradiol on Endothelium-Dependent Vascular Function in Postmenopausal Women
Andrew Sherwood *;
From the Duke University Medical Center (A.S., J.K.B., J.M., J.A.B., L.K.N.), Durham, and the University of North Carolina at Chapel Hill (A.L.H.).
* To whom correspondence should be addressed. E-mail: sherw002{at}mc.duke.edu.
Objective--We evaluated age and coronary heart disease (CHD) as potential moderators of the effects of 17
-estradiol on vascular endothelial function in postmenopausal women.
Methods and Results--In a double-blind crossover design, 100 postmenopausal women aged 50 to 80 years were randomized to each of 3 transdermal patches, releasing 17-estradiol (0.05 mg/d), 17-estradiol (0.05 mg/d)+ norethindrone acetate (NETA, 0.14 mg/d), and placebo. Flow-mediated dilation (FMD) and response to 400 µg sublingual glyceryl trinitrate (GTN-D) were assessed approximately 18 hours after patch placement. Age, but not CHD, moderated the FMD response to treatment (P=0.01). For women in their fifties, the estradiol patch was associated with improved FMD (7.69±4.79%) compared with placebo (4.81±5.97%, P<0.05), but the estradiol+norethindrone patch response (5.81±4.85%) was not significantly different from placebo. Women in their sixties and seventies showed no alterations in FMD response to either active patch. GTN-D response declined with advancing age (P<0.01), with women in their seventies exhibiting blunted GTN-D response compared with younger women.
Conclusions--The cardiovascular benefits of natural estrogen supplementation on vascular endothelial function may be dependent on postmenopausal age, with improved vascular function evident only in the early postmenopausal years. Short-term FMD response to estradiol might help stratify individual differences in risks versus benefits of HRT.
Key words: aging • coronary disease • endothelium • hormones • women
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- Hormone Replacement Therapy and Atherosclerosis in Postmenopausal Women: Does Aging Limit Therapeutic Benefits?
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