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Abstract

Arterial hypertension and atherosclerosis are associated with impaired release of endothelium derived nitric oxide and increased levels of low-density lipoproteins (LDL).

The purpose of the study was to assess the influence of combined transdermal hormone replacement therapy (HRT) on nitric oxide release (NOx) its correlation with LDL cholesterol level in hypertensive postmenopausal women.

Material and methods: The study comprised 66 women (mean age 51.1*6.8 years) with mild and moderate EH (mean duration 5.9 * 5.0) after menopause. Thirty-six women received HRT (17-b-estradiol and norethisterone acetate, TTS), whereas 30 women without HRT served as controls. At baseline and at 3 months both groups underwent maximal treadmill exercise testing (Case 15, Marquette Electronics Inc.) according to Bruce's protocol. Nitrate/nitrite concentration (Griess's method) level were measured before, at peak and immediately after exercise. In all women ambulatory blood pressure monitoring (SpaceLabs 90207) was obtained. At baseline both group were similar with respect to age, BMI, duration of hypertension, blood pressure values and variability.

Results: Serum NOx levels did not increase significalntly in all the postmenopausal women receiving HRT, however in 51 % of patients after three months and in 54 % of patients after 12 months singificant increase in NOx level was observed comparing to baseline (17,8 + 6,7 vs 32,8 + 14,5 vs 28,7 + 11,1 umol/l; p=0,002). LDL cholesterol level in this group was significantly lower after 12 months of HRT (3,62 + 1,2 vs 3,53 + 1,3 vs 2,6 + 0,6 mmol/l; p=0,01). In the group without HRT there was no change in NOx levels and cholesterol level after 3 and 12 months of follow-up.

Conclusion: Significant increase of NOx in half of patients with hypertension receiving HRT suggest existence of responders and nonresponders to postmenopausal hormone replacement therapy with respect to improvement of endogenous NO levels, suggesting that a significant number, but not all, of the hormonally substituted women profit fully from beneficial properties of HRT.

postmenopausal women, nitric oxide, hormone replacement therapy
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© American Journal of Hypertension, Ltd. 2001
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