The effect of hormone replacement therapy on arterial blood pressure and vascular compliance in postmenopausal women with arterial hypertension
The effect of hormone replacement therapy on arterial blood pressure and vascular compliance in postmenopausal women with arterial hypertension
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DOI：
10.1038/sj.jhh.1001431
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发表时间：
2002-07-01
影响因子：
2.7
通讯作者：
Jankowski, P
中科院分区：
文献类型：
--
作者：
Kawecka-Jaszcz, K;Czarnecka, D;Jankowski, P
动脉病理是心血管疾病、发病率和死亡率的主要因素。更年期后，女性患心血管疾病的风险更高。动脉硬度由脉搏波速度决定，在男性和女性中，随着年龄的增长而增加，而绝经前女性的动脉顺应性比同龄男性更大。这种差异在绝经后几年消失，有证据表明动脉顺应性在围绝经期迅速下降。荷尔蒙调节功能丧失可能是绝经后女性动脉顺应性降低的一个可能原因。激素替代疗法(HRT)的长期治疗有望部分逆转动脉僵硬的增加。本研究的目的是分析HRT对接受降压药治疗的绝经后高血压妇女的血压和动脉顺应性的影响。目前对患有轻中度动脉高血压的绝经后妇女接受HRT治疗的结果显示，只有一过性的血压下降趋势。在我们的研究中，HRT被发现在HRT后3个月改善动脉顺应性，并在整个12个月内保持这种效果。接受HRT的妇女的动脉顺应性增加与血压无关。在脉搏波速度下降的同时，接受HRT的女性总胆固醇和低密度脂蛋白胆固醇较低。结论：绝经后高血压患者接受HRT治疗1年后，血压昼夜节律得到改善，但对血压值和血压变异性无明显影响。目前的研究还表明，HRT显著抑制了与年龄相关的大动脉僵硬。
Arterial pathology is a major contributor to cardiovascular disease, morbidity and mortality. Women are at higher risk of cardiovascular disease after menopause. Arterial stiffness determined by pulse wave velocity, increases with age both in men and women, whereas arterial compliance in premenopausal women is greater than in men of similar age. This difference is lost in the postmenopausal years, with evidence of rapid decline in arterial compliance in the perimenopausal period. Loss of hormonal modulation is a likely explanation for reduced arterial compliance in postmenopausal women. Long-term treatment with hormone replacement therapy (HRT) may be expected to partially reverse the increase in arterial stiffness. The aim of the study was to analyse the effect of HRT on blood pressure and arterial compliance in postmenopausal women with arterial hypertension receiving hypotensive drugs. The results in the present study of postmenopausal women with mild to moderate arterial hypertension receiving HRT showed only a transient tendency towards lower blood pressure. In our study HRT was found to improve arterial compliance at 3 months after HRT, and the effect was maintained throughout 12 months. The increased arterial compliance in women receiving HRT was independent of blood pressure. In parallel with decreasing pulse wave velocity women receiving HRT had lower total and low-density lipoprotein cholesterol. The conclusions were that after 1 year HRT in postmenopausal women with arterial hypertension improves circadian blood pressure pattern, but it does not affect significantly blood pressure values and variability. The present study also shows that HRT significantly inhibits age-related rigidity of large arteries.