Effects of long-term transdermal hormone replacement therapy on the renin-angiotensin- aldosterone system, plasma bradykinin levels and blood pressure in normotensive postmenopausal women
Effects of long-term transdermal hormone replacement therapy on the renin-angiotensin- aldosterone system, plasma bradykinin levels and blood pressure in normotensive postmenopausal women
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DOI：
10.1111/j.1447-0594.2008.00474.x
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发表时间：
2008-12-01
影响因子：
3.3
通讯作者：
Nitta, Kosaku
中科院分区：
文献类型：
--
作者：
Ichikawa, Akiko;Sumino, Hiroyuki;Nitta, Kosaku
本研究旨在探讨24个月长期经皮激素替代疗法（HRT）对正常血压的绝经后妇女（PMW）肾素-血管紧张素-醛固酮系统（RAAS）和缓激肽循环成分水平、血压（BP）和血脂的影响。22名血压正常的PMW随机接受透皮HRT治疗（连续36 μ g/天的17- β雌二醇贴剂加环口服醋酸甲孕酮2.5 mg/天，连续12天/月）（n = 12）或对照组（n = 10）。分别于HRT开始前、12、24个月测定血浆肾素活性（PRA）、血清血管紧张素转换酶（ACE）活性、血浆血管紧张素（Ang） I、Ang II、醛固酮、缓激素、血压。HRT组患者在开始治疗后12个月和24个月的舒张压和平均血压均显著降低（P < 0.05），但在研究期间，收缩压无明显变化。两组均未发现RAAS成分或脂质谱的变化。血浆缓激肽水平在12个月和24个月时显著降低（P < 0.05），而对照组无变化。长期经皮HRT治疗超过12个月后，正常PMW患者的舒张压、平均血压和血浆缓激肽水平均下降，而不影响RAAS的任何成分。这种疗法可以使血压得到最佳控制，并防止心血管风险的升高。
This study was designed to investigate the effects of 24-month long-term transdermal hormone replacement therapy (HRT) on the circulating levels of components of the renin-angiotensin-aldosterone system (RAAS) and bradykinin, blood pressure (BP) and lipid profile in normotensive postmenopausal women (PMW).Twenty-two normotensive PMW were randomized to receive transdermal HRT (continuous 17-beta estradiol patch at 36 mu g/day plus cyclic oral medroxyprogesterone acetate 2.5 mg/day for 12 days/month) (n = 12) or control (n = 10). The plasma renin activity (PRA), serum angiotensin-converting enzyme (ACE) activity, plasma angiotensin (Ang) I, Ang II, aldosterone, bradykinin, and BP were measured before, and 12 and 24 months after, the start of the HRT.In the HRT group, the diastolic BP and mean BP were significantly decreased at 12 and 24 months (both P < 0.05) after the start of therapy, however, no significant change of the systolic BP was noted during the study period. No changes in the RAAS components or lipid profile were noted in either group. The plasma bradykinin levels were significantly reduced at 12 (P < 0.05) and 24 months (P < 0.01), while no changes were observed in the control group.More than 12 months of long-term transdermal HRT kept diastolic BP, mean BP and plasma bradykinin levels decreased in normotensive PMW, without influencing any of the components of the RAAS. This therapy may allow optimal blood pressure control and prevent elevation of the cardiovascular risk.