Postmenopausal oral estrogen therapy and blood pressure in normotensive and hypertensive subjects: the Estrogen in the Prevention of Atherosclerosis Trial.
OBJECTIVE
To determine if 17beta-estradiol increases blood pressure in postmenopausal women.


METHODS
A total of 222 healthy postmenopausal women were randomly assigned to either 1 mg micronized 17beta-estradiol daily or placebo for 2 years. Blood pressure measurements were obtained every other month and common carotid artery intima-media thickness measured every 6 months. Statistical analyses comparing longitudinal changes in systolic and diastolic blood pressure between treatment groups used a mixed general linear model including interaction terms to evaluate variations by age or estradiol level.


RESULTS
Both placebo and estradiol groups showed small declines in systolic and diastolic blood pressure during the trial among the normotensive subjects and subjects on antihypertensive medications. However, the decline did not differ significantly between the groups. Treatment effects on systolic blood pressure differed significantly by the age of the subject (interaction P value = 0.04) with younger women on estradiol showing on average a rise in systolic blood pressure, and older women a decline. The association between serum estradiol level and systolic blood pressure showed a similar modification with age (P = 0.03). Changes in systolic blood pressure in women on estradiol were positively correlated with intima-media thickness progression (P = 0.03).


CONCLUSIONS
Overall, 17beta-estradiol did not influence changes in blood pressure in normotensive or hypertensive women. The effect of 17beta-estradiol treatment on systolic blood pressure may be influenced by a woman's age. Estradiol may increase systolic blood pressure in younger postmenopausal women, while having the opposite effect in older postmenopausal women.
Steiner
Anne Z
AZ
Department of Obstetrics and Gynecology, University of Southern California/Keck School of Medicine, Los Angeles, CA 90033, USA.
Hodis
Howard N
HN
Lobo
Rogerio A
RA
Shoupe
Donna
D
Xiang
Min
M
Mack
Wendy J
WJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000517:prevention & control; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D015331:Cohort Studies; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged; D017698:Postmenopause; D012907:Smoking
D004958:Estradiol