Influence of 17β-oestradiol on blood pressure of postmenopausal women at high vascular risk
Influence of 17β-oestradiol on blood pressure of postmenopausal women at high vascular risk
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DOI：
10.1097/00004872-200112000-00004
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发表时间：
2001-12-01
影响因子：
4.9
通讯作者：
von Schacky, C
中科院分区：
文献类型：
--
作者：
Angerer, P;Störk, S;von Schacky, C
目的激素替代疗法（HRT）是否能降低血压一直是一个悬而未决的问题。这项随机试验检查了17 β-雌二醇与孕二烯酮周期性联合对未服用抗高血压药物的绝经后妇女血压的影响。226名绝经后妇女随机接受口服治疗48周，每天连续服用1 mg 17 β-雌二醇，在每个4周周期（HRT 1）的第17-28天加上0.025mg孕二烯酮，或每三个周期仅加孕二烯酮（HRT 2），或不加HRT。根据预先确定的标准，从分析中排除了4例HRT 1组、12例HRT 2组和13例开始接受降压药物治疗的非HRT组受试者。30例受试者因其他原因提前结束参与。结果HRT 2组、HRT 1组和无HRT组在治疗过程中舒张压均较无HRT组显著变化，第48周分别为-3.7 +/-9.8mmHg、-3.0 +/-8.8mmHg和1.0 +/-9.9mmHg，差异有统计学意义（P < 0.05）。（HRT 2组与无HRT组相比P = 0.008，HRT 1组与无HRT组相比P = 0.027）。开始时舒张压越高，下降幅度越大。收缩压的下降并没有显着差异groups.Conclusions绝经后妇女心血管疾病的高风险，但没有抗高血压药物，长期治疗与17 β-雌二醇结合孕二烯酮降低舒张压。J Hypertens 19：2135-2142（C）2001 Lippincott威廉姆斯和威尔金斯。
Objectives It remains an unsolved issue whether hormone replacement therapy (HRT) lowers blood pressure. This randomized trial examined the effect of 17 beta -oestradiol combined cyclically with gestodene on blood pressure of postmenopausal women who were not on antihypertensive medication. All subjects had an increased risk for adverse vascular events as indicated by intima-media thickness of carotid arteries and standard risk factors.Design and setting Two hundred and twenty-six postmenopausal women were randomized to oral treatment for 48 weeks with 1 mg of 17 beta -oestradiol per day continuously, plus 0.025 mg gestodene on days 17-28 of each 4-week cycle (HRT 1), or plus gestodene in each third cycle only (HRT 2), or no HRT. According to predefined criteria, four subjects in HRT 1, 12 in HRT 2 and 13 in no HRT who were started on antihypertensive medication were excluded from the analysis. Thirty subjects ended participation prematurely for other reasons. Resting blood pressure was measured at baseline and after 12, 22 and 48 weeks.Results During treatment diastolic blood pressure changed significantly in both HRT groups compared to no HRT, by -3.7 +/- 9.8 mmHg, -3.0 +/- 8.8 mmHg and 1.0 +/- 9.9 mmHg at week 48 in groups HRT 2, HRT 1 and no HRT, respectively (P = 0.008 for HRT 2 versus no HRT, P = 0.027 for HRT 1 versus no HRT). The higher the diastolic blood pressure was at beginning the greater was the decrease. The decrease of systolic blood pressure was not significantly different between groups.Conclusions For postmenopausal women with high cardiovascular risk but without anti hypertensive medication, long-term treatment with 17 beta -oestradiol combined with gestodene lowers diastolic blood pressure. J Hypertens 19:2135-2142 (C) 2001 Lippincott Williams & Wilkins.