The effect of hormone replacement therapy on blood pressure and cardiovascular risk factors in menopausal women with moderate hypertension.
OBJECTIVE
To assess the effect of injectable hormone replacement therapy (HRT) vs a placebo in hypertensive menopausal women.


METHODS
Prospective randomised double-blind study over 90 days. Fifty-five menopausal women with mild to moderate hypertension, stopped their antihypertensive medication and were studied for 2 weeks. Diastolic BP increased to over 105 mm Hg in five patients who were not included in the study. The remaining patients were randomly allocated to three groups: placebo (PL), estradiol valeranate 10 mg (E), and estradiol valeranate 4 mg plus prasterone enantate 200 mg (E+P). A further five patients were excluded from the study for different reasons.


RESULTS
Standing and recumbent BP decreased in the PL group but did not change in the E and E+P patients. No change was observed in the serum levels of total cholesterol or low density lipoprotein (LDL)-cholesterol at the end of the trial. Plasma renin activity (PRA), aldosterone and insulin levels decreased during the study; PRA fell more significantly in the E+P group, the aldosterone reduction was highly significant in both hormone treated groups, specially the E+P group. Plasma insulin decreased in all groups and FSH levels were lower in the two treatment groups.


CONCLUSIONS
In a randomised controlled trial no rise in BP was found after 90 days in hypertensive women with two forms of HRT. There was an unexpected fall in BP in those women allocated to placebo injections.
Kornhauser
C
C
Instituto de Investigaciones Médicas, León, Gto, Mexico.
Malacara
J M
JM
Garay
M E
ME
Pérez-Luque
E L
EL
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000209:etiology*; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D012083:Renin / Q000097:blood; D012307:Risk Factors
D008055:Lipids; D012083:Renin