Effects of hormone replacement therapy on cardiovascular responses in postmenopausal women with and without type 2 diabetes.
OBJECTIVE
To determine whether blood pressure (BP) responses to pressor stimuli during hormone replacement therapy are reduced by oral conjugated equine estrogens 0.625 mg/day (ERT) and ERT in combination with 5 mg/day continuous medroxyprogesterone (HRT) in women with and without type 2 diabetes.


METHODS
Twenty type 2 diabetic and 20 non-diabetic women completed a three period, randomised, double bind crossover studying the effects of 1 month of therapy of ERT, HRT and placebo on BP responses to mental arithmetic and isometric stress and to intravenous infusions of noradrenaline and angiotensin II.


RESULTS
Significant differences were found between the effects of ERT, HRT and placebo therapy on BP responses to mental arithmetic in the women with type 2 diabetes apparently due to a smaller response during ERT therapy. BP responses to mental arithmetic were not affected in non-diabetic women. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II were similar in the type 2 diabetic and non-diabetic women and were not affected by ERT or HRT therapy. Plasma renin activity differed significantly between ERT, HRT and placebo therapies in type 2 diabetic women, apparently because of lower levels during ERT and HRT therapy.


CONCLUSIONS
ERT and HRT may produce beneficial effects on BP responses to psychological stress and on plasma renin activity in women with type 2 diabetes. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II are not altered by ERT or HRT in type 2 diabetic or non-diabetic women.
Manwaring
Paul
P
Department of Clinical Pharmacology, St. George Hospital, University of New South Wales, Gray Street, NSW 2217, Kogarah, Australia.
Phoon
Stephen
S
Diamond
Terence
T
Howes
Laurence Guy
LG
D000284:Administration, Oral; D000804:Angiotensin II; D001794:Blood Pressure / Q000187:drug effects*; D002319:Cardiovascular System / Q000187:drug effects*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D009638:Norepinephrine; D017698:Postmenopause; D013312:Stress, Physiological / Q000139:chemically induced / Q000378:metabolism; D016896:Treatment Outcome
D004966:Estrogens, Conjugated (USP); D000804:Angiotensin II; D008525:Medroxyprogesterone; D009638:Norepinephrine