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Valeria Ferrero, Antonella Deorsola, Giovanni Ugliengo, Mauro Feola, Flavio Ribichini, Antonello Vado, Eugenio Principe, Bruno Favilla, Pietro Leli, PierDino Rattazzi, Eugenio Uslenghi, P-690: Six-month effects of the hormone replacement therapy on arterial wave reflection, blood pressure and plasma level of angiotensin-I converting enzyme in postmenopausal healthy women, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 261A, https://doi.org/10.1016/S0895-7061(01)02038-6
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Abstract
In postmenopausal women the incidence of coronary events is increased. The cardioprotective effects of hormone replacement therapy (HRT), observed in primary prevention trials, may in part be due to the effects of estrogens on arterial wall stiffness. Angiotensin-I Converting Enzyme (ACE) is involved in the regulation of vascular tone and its action seems to be more important after estrogen's drop.
Between April 1999 and June 2000, 47 postmenopausal healthy normotensive women started HRT. Plasma ACE level, Pulse Wave Velocity (PWV) of the carotid-femoral segment and 24-hour ambulatory blood pressure monitoring (ABPM) were assessed before and after 6 months of HRT. The pre-treatment results were: age: 54±4 (range 45-61 years); basal ACE level: 27±17, (range 3-74 U/L); basal PWV: 10,5±2, (range 7-15 m/s); and 24-hour ABPM: mean systolic 117±9, mean diastolic 74±7 mmHg. No correlation was found between basal ACE level and basal PWV (r=0.06) or basal ABPM (systolic r=0.1, diastolic r=0.2). Arterial stiffness increased with age (r=0.1), although not significantly (p=0.3). So far, 6-month follow-up was obtained in 35/47 treated women. No differences were observed between the basal and the follow-up paired data as to: PWV (10,53±2 vs 10,46±2; p=0.8), mean systolic pressure (121±9 vs 121±7; p=1) and mean diastolic pressure (76±7 vs 76±7; p=0,7). However, HRT caused a significant reduction of the basal plasma ACE level (27,8±19 vs 19,3±14; p=0.04).
In conclusion, arterial distensibility and blood pressure were not modified by the first six months of HRT, but plasma ACE level were significantly reduced in this population of healthy women. This indirect intervention on plasma ACE level may be involved in the long-term effect of HRT.
