Dose response effect of conjugated equine oestrogen on blood pressure in postmenopausal women with hypertension.
OBJECTIVE
This study was designed to compare with placebo the dose-response of conjugated equine oestrogen (CEE) on blood pressure in hypertensive postmenopausal women.


METHODS
Fourteen postmenopausal women with grade 1-2 hypertension participated in the study which used a double-blind crossover design. There were four randomised treatment phases, each lasting 4 weeks. The four treatments were CEE 0.3 mg, CEE 0.625 mg, CEE 1.25 mg and placebo. Each subject also received non-blinded medroxyprogesterone acetate (MPA) 10 mg for the final 14 days of each 28-day treatment cycle. Clinic blood pressure was measured weekly with the mean values of weeks 3 and 4 of each phase used for analysis. Ambulatory blood pressure was performed in week 4 of each phase.


RESULTS
Compared with placebo, clinic systolic blood pressure was reduced in the CEE 0.3 mg and CEE 0.625 mg phases (p < 0.05) and clinic diastolic blood pressure was reduced in the CEE 0.625 mg phase (p < 0.05). There was no significant effect of CEE on ambulatory blood pressure, although the blood pressure pattern was similar to clinic measurements.


CONCLUSIONS
In hypertensive postmenopausal women, daily CEE together with cyclical MPA has a variable effect on blood pressure depending on CEE dose. The "lower" and "middle" doses of CEE produced a small reduction in blood pressure which reached a nadir and tended to reverse with the "higher" CEE dose.
Harvey
P J
PJ
Department of Clinical Pharmacology, Flinders University of South Australia, Adelaide, Australia. paula.harvey@utoronto.ca
Molloy
D
D
Upton
J
J
Wing
L M
LM
D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D018592:Cross-Over Studies; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004958:Estradiol / Q000097:blood; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D017698:Postmenopause; D012083:Renin / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013599:Systole / Q000187:drug effects
D004966:Estrogens, Conjugated (USP); D012738:Sex Hormone-Binding Globulin; D000450:Aldosterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D017258:Medroxyprogesterone Acetate; D012083:Renin