on December 6, 2007
Published online before print December 6, 2007, doi: 10.1161/ATVBAHA.107.158634
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Submitted on September 14, 2007
Accepted on November 21, 2007
Time Since Menopause Influences the Acute and Chronic Effect of Estrogens on Endothelial Function
Cristiana Vitale *;
From the Department of Internal Medicine (C.V., G. Marazzi, M.V., M.F., G.M.C.R.), IRCCS San Raffaele, Roma, Italy; the Department of Cardiovascular and Neurological Sciences (G. Mercuro), University of Cagliari, Italy; the Department of Cardiology (E.C.), Policlinico Luigi Di Liegro, Roma, Italy; the Department of Cardiology (R.P.), Policlinico Casilino, Roma, Italy; and the Department of Cardiac Medicine (P.C.), Imperial College London, Royal Brompton Hospital, London, UK.
* To whom correspondence should be addressed. E-mail: cristiana.vitale{at}sanraffaele.it.
Objective—We evaluated whether time since menopause influences the acute and chronic effect of Estradiol (E) on vascular endothelial function.
Methods and Results—We studied flow-mediated dilatation (FMD) in 134 postmenopausal women (PMW) before and after acute and chronic E administration. At baseline FMD was inversely associated to time from menopause (r=-0.67, P<0.001) and age (r=-0.43, P<0.05), in exogenous estrogen naïve but not in previous users. Acute and chronic E improved endothelial function in all women. E administration improved FMD more in women within 5 years since menopause than in those with more than 5 years since menopause (76% and 74% versus 45% and 48%, acute and chronic E, respectively; P<0.05). Among women with more than 5 years since menopause acute and chronic E increased FMD more in previous E users than in nonusers (59% and 63% versus 31% and 38%, acute and chronic E, respectively; P<0.01). Multivariate analysis showed that time from menopause was a predictor of impaired FMD and of its improvement after acute and chronic E.
Conclusions—Time from menopause influences FMD in PMW. The acute and chronic effect of E on FMD is time dependent and is reduced by a longer time since menopause.
Key words: endothelium • endothelial function • cardiovascular disease prevention • risk factors • estrogen
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