title: Hormone replacement therapy and endothelial function. Results of a randomized controlled trial in healthy postmenopausal women.
abstract: OBJECTIVE
  To compare the effects of 3 months treatment with tibolone (a single entity synthetic steroid hormone with estrogenic, progestanic and androgenic activities), or continuous combined conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA), with placebo, on endothelial function.
  
  
  METHODS
  A single center, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Research center as part of the University Medical Center Utrecht.
  
  
  METHODS
  One hundred and five healthy postmenopausal women, sampled from the general population.
  
  
  METHODS
  Three months treatment with tibolone or CEE+MPA or placebo.
  
  
  METHODS
  At baseline and after 3 months, endothelial function was assessed non-invasively by measuring percent lumen diameter change in the brachial artery after reactive hyperemia and sublingual nitroglycerine spray.
  
  
  RESULTS
  Results are presented as mean differences between treatment groups of endothelium dependent flow mediated dilatation (fmd) and endothelium independent nitroglycerine induced dilatation with 95% confidence intervals (95% CI). After treatment, there was a significant difference in mean fmd between the CEE+MPA group and the placebo group of 2.5% (95% CI: 0.3-4.6) while the tibolone group and the placebo group did not differ significantly (0.6%; 95% CI: 1.6-2.8). Nitroglycerine induced dilatation did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Hormone replacement therapy with CEE+MPA for 3 months increases endothelium dependent fmd of the brachial artery in healthy postmenopausal women. Tibolone did not alter fmd. The clinical significance of this improvement in fmd for cardiovascular disease risk needs to be established.
authors.affiliation: Julius Center for General Practice and Patient Oriented Research, University Medical Center Utrecht, HP D01.335, PO Box 85500, 3508 GA, Utrecht, The Netherlands
authors.forename: M J
authors.initials: MJ
authors.lastname: de Kleijn
authors.forename: H W
authors.initials: HW
authors.lastname: Wilmink
authors.forename: M L
authors.initials: ML
authors.lastname: Bots
authors.forename: A A
authors.initials: AA
authors.lastname: Bak
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: J
authors.initials: J
authors.lastname: Planellas
authors.forename: S
authors.initials: S
authors.lastname: Engelen
authors.forename: J D
authors.initials: JD
authors.lastname: Banga
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D008875:Middle Aged; D009652:Norpregnenes / Q000627:therapeutic use*; D017698:Postmenopause; D012016:Reference Values
chemical_list: D004966:Estrogens, Conjugated (USP); D009652:Norpregnenes; C027385:tibolone; D008525:Medroxyprogesterone