Carotid and uterine vascular resistance in short-term hormone replacement therapy postmenopausal users.
OBJECTIVE
To compare the short-term effects of oral hormone replacement therapy (HRT) and placebo on carotid and uterine vascular impedance.


METHODS
80 postmenopausal women selected from the outpatient clinic of the Hospital Leonor Mendes de Barros in São Paulo, Brazil, were randomized to oral HRT (estradiol 2 mg/norethisterone acetate 1 mg-Kliogest(r)) or placebo. Carotid and uterine arteries pulsatility indices (PIs) were assessed by color Doppler at baseline, after 4 and 12 weeks of treatment. Seventy-six women completed the trial, 38 in each group.


RESULTS
The carotid PI did not decrease significantly in either group. In the uterine arteries, the drop in PI was steeper and greater for HRT women. Drops occurred despite the supposed counteracting effect of norethisterone acetate. In placebo group, there was no significant difference between 4 and 12 weeks of treatment compared with the baseline. The results did not change when analyzed in a real treatment approach.


CONCLUSIONS
Oral continuous HRT are effective at 12 weeks in reducing impedance to flow in uterine, but not in carotid circulation. These results suggest that the effects of HRT vary by vascular site, and do not have a detectable short-term vascular effect in the carotid area.
Department of Obstetrics and Gynecology, Medical Sciences School, University of Campinas (Unicamp), R. Alexander Fleming 101, 13083-970 Campinas, SP, Brazil. flj@uol.com.br
Felipe
F
Lazar
Lucia
L
Costa-Paiva
Aarão Mendes
AM
Pinto-Neto
Edson Zangiacomi
EZ
Martinez
D000704:Analysis of Variance; D001938:Brazil; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D004311:Double-Blind Method; D004717:Endometrium / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects*; D004958:Estradiol / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D010045:Outpatients; D010919:Placebos; D017698:Postmenopause / Q000187:drug effects / Q000378:metabolism; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods
D010919:Placebos; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone