title: Effects of oral and transdermal hormone replacement therapy on internal carotid artery pulsatility indices in postmenopausal women. A prospective, randomized, comparative study.
abstract: OBJECTIVE
  To compare the effects of oral and transdermal hormone replacement therapy on the internal carotid artery pulsatility index in postmenopausal women.
  
  
  METHODS
  Thirty-seven women were randomized to six months of treatment with oral (n = 19) or transdermal (n = 18) sequential combined hormone replacement therapy. The internal carotid artery pulsatility index was assessed by color Doppler ultrasound at baseline and after six months of treatment.
  
  
  RESULTS
  Carotid artery pulsatility indices were significantly lower than the mean of 0.939 +/- 0.139 at 0.860 +/- 0.084 in the oral hormone replacement group and significantly lower than the mean of 0.928 +/- 0.092 at 0.891 +/- 0.046 in the transdermal hormone replacement therapy group (P = .042) after six months of treatment. The mean changes in the carotid artery pulsatility index between the oral and transdermal hormone replacement groups were nonsignificant (-0.078 +/- 0.131 and -0.037 +/- 0.067, respectively; P = .53). There was a significant negative correlation between the change in pulsatility index during treatment and baseline values in the carotid artery (r = -.81, P = .001), but no correlation was found with time since menopause and serum estradiol level.
  
  
  CONCLUSIONS
  Oral and transdermal sequential hormone replacement therapy are similarly effective at six months in reducing impedance to flow in the internal carotid artery.
authors.affiliation: Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Bornova, Izmir 35100, Turkey. sendag@med.ege.edu.tr
authors.forename: F
authors.initials: F
authors.lastname: Sendağ
authors.forename: M C
authors.initials: MC
authors.lastname: Terek
authors.forename: N
authors.initials: N
authors.lastname: Karadadaş
authors.forename: O
authors.initials: O
authors.lastname: Bilgin
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002343:Carotid Artery, Internal / Q000187:drug effects* / Q000503:physiopathology; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects* / Q000502:physiology
chemical_list: D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D004958:Estradiol; D000077563:Norethindrone Acetate; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone