HRT slows systolic blood pressure elevation in postmenopausal women

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WESTPORT, CT (Reuters Health) – Postmenopausal women who receive hormone replacement therapy (HRT) experience an attenuated increase in systolic blood pressure compared with untreated women.

As women age, the systolic and diastolic blood pressures tend to increase. Previous studies investigating whether HRT influences these changes have yielded conflicting results, Dr. Jerome L. Fleg, from the National Institutes of Health, in Baltimore, and colleagues note in the August 21st issue of the Annals of Internal Medicine.

Dr. Fleg's team conducted a longitudinal observational study of 226 healthy, normotensive postmenopausal women, 77 of whom were treated with estrogen/progestin HRT. On average, the women were mean of 64 years of age and were followed for a mean of 5.7 years.

HRT users had an average systolic blood pressure increase between their first and last visit of 1.6 mm Hg, significantly less than the 8.9 mm Hg increase noted in HRT nonusers, the authors state (p < 0.01). This finding was influenced by the age at initial visit and the effect was most evident in women treated at older ages. Neither group experienced a significant change in diastolic blood pressure during the study period.

"Structural changes in the arterial wall may be a mechanism through which HRT exerts effects on arterial stiffness and systolic blood pressure," the researchers postulate. "Increased nitric oxide production may be an additional mechanism by which HRT reduces the change in systolic blood pressure over time," they add.

"Additional longitudinal studies are needed to confirm [the current findings]," the investigators conclude.

Ann Intern Med 2001;135:229-238.

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