title: Combined hormone replacement therapy improves endothelial function in healthy postmenopausal women.
abstract: OBJECTIVE
  Large scale epidemiological studies suggest that hormone replacement therapy (HRT) reduces cardiovascular events in postmenopausal women. Improvement in endothelial function may contribute to this protective effect.
  
  
  METHODS
  In a prospective, double blind study, 61 healthy postmenopausal women were randomized to receive either oral continuous combined HRT [oestradiol 2 mg and norethisterone acetate (NETA) 1 mg per day] or placebo. Endothelial function, assessed by flow-mediated vasodilation (FMD) of the brachial artery and expression of soluble endothelial cell adhesion molecules (CAM) were determined before, after 3 and 6 months of therapy.
  
  
  RESULTS
  The FMD was significantly improved in women on combined HRT (from 5.97% to 10.94% after 3 months and to 10.58% after 6 months; both P < 0.01 versus baseline values) and did not change in the placebo group (6.92% at baseline, 5.86% after 3 and 6.26% after 6 months). After 3 months of combined HRT, significant decreases of 24.6% for E-selectin and 13.9% for intercellular adhesion molecule-1 (ICAM-1) were observed (both P < 0.01 versus baseline values) and were sustained after 6 months of therapy, whilst no differences emerged in the placebo group.
  
  
  CONCLUSIONS
  Oestradiol and norethisterone acetate improve endothelial function by both enhancing FMD and reducing the levels of soluble E-selectin and ICAM-1 in healthy postmenopausal women.
authors.affiliation: Department of Angiology, University Medical Centre, Ljubljana, Slovenia. barbara.guzic@trnovo.kclj.si
authors.forename: B
authors.initials: B
authors.lastname: Guzic-Salobir
authors.forename: I
authors.initials: I
authors.lastname: Keber
authors.forename: I
authors.initials: I
authors.lastname: Seljeflot
authors.forename: H
authors.initials: H
authors.lastname: Arnesen
authors.forename: L
authors.initials: L
authors.lastname: Vrabic
mesh_terms: D000704:Analysis of Variance; D001916:Brachial Artery; D015815:Cell Adhesion Molecules / Q000097:blood*; D004311:Double-Blind Method; D004338:Drug Combinations; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D017698:Postmenopause / Q000187:drug effects; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014664:Vasodilation / Q000187:drug effects
chemical_list: D015815:Cell Adhesion Molecules; D004338:Drug Combinations; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone