One year follow-up of hormone replacement therapy with percutaneous estradiol and low-dose vaginal natural progesterone in women with mild to moderate hypertension.
OBJECTIVE
The effects of natural estradiol and progesterone replacement therapy on lipoprotein and cardiovascular parameters were assessed in 20 postmenopausal women with mild to moderate systemic arterial hypertension.


METHODS
After confirming hypertension in the absence of antihypertensive treatment, blood pressure control was achieved by administration of amlodipine at individually adjusted doses. Hormone replacement therapy (HRT) was introduced in a cyclic regimen (21 of 28 days) with percutaneous estradiol (1.5 mg/day) and vaginal micronized progesterone (100 mg/day).


RESULTS
Blood pressure and mean heart rate remained unchanged during HRT. Serial echocardiograph scans showed no change in left ventricle mass, but a significant reduction in the thickness of the left ventricular posterior wall was observed. During treatment, patients showed little variation in total cholesterol levels (baseline: 199+/-10 mg/dl, 12 months: 202+/-11 mg/dl), as well as in high-density lipoprotein (53+/-2 to 50+/-3 mg/dl), low-density lipoprotein (122+/-10 to 118+/-11 mg/dl), and triglycerides (111+/-13 to 126+/-13 mg/dl). A subgroup of 10 patients with initial total cholesterol levels >200 mg/dl responded to HRT with a slight but significant decrease of cholesterol levels after 12 months (265+/-10 to 237+/-12 mg/dl, p<0.05, repeated measures ANOVA). HRT did not change mean antithrombin III levels and affected neither plasma renin activity nor aldosterone levels.


CONCLUSIONS
These results suggest that the proposed HRT regimen with percutaneous estradiol associated with low-dose vaginal micronized progesterone could be a safe alternative for postmenopausal women with hypertension at least during the period required to treat menopausal symptoms.
Spritzer
P M
PM
Gynecological Endocrinology Unit, Division of Endocrinology, University Hospital, Brazil. spritzer@vortex.ufrgs.br
Vitola
D
D
Vilodre
L C
LC
Wender
M C O
MC
Reis
F M
FM
Ruschel
S
S
Castro
I
I
D000279:Administration, Cutaneous; D000282:Administration, Intravaginal; D000450:Aldosterone / Q000097:blood; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D011187:Posture; D011374:Progesterone / Q000008:administration & dosage*; D012083:Renin / Q000097:blood; D013997:Time Factors; D014621:Vagina
D000959:Antihypertensive Agents; D017311:Amlodipine; D000450:Aldosterone; D011374:Progesterone; D004958:Estradiol; D012083:Renin