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P151 Menopause and impaired endothelial function in caucasian but not in Chinese women
P151
P152
MENOPAUSE AND IMPAIRED ENDOTHELIAL FUNCTION IN CAUCASIAN BUT NOT IN CHINESE WOMEN.
UTERINE NOTCHING IN THE MENOPAUSE REFLECTS THE ARTERIAL STATUS AND THE ARTERIAL EFFECT OF HRT
JA McCrohon, KS Woo*, JT Robinson, DS Celermajer. Department of Cardiology, University, Hong Kong.
RPAH, Sydney, Australia.
A Jakab Jr, L Ovari, Z Toth, A Balogh,
*The Chinese
Department of Obstetrics and Gynaecology, University Medical School of Debrecen, PO Box 37, H-4012, Debrecen, Hungary
After the menopause, arterial endothelial function (a key event in atherogenesis) becomes progressively impaired in Caucasians. We hypothesised that the menopause-related decrease in endothelial function might be less marked in Chinese women, in whom vascular events are much less common. We studied endothelial function in 20 women (10 aged 20-35 yrs, pre-menopausal; 10 aged 55-66 yrs, post-menopausal) in Southern China, and 20 age-matched Caucasian women in Sydney, Australia. None were taking any cardiac or hormonal therapy. Using ultrasound, brachial artery diameter was measured at rest and after flow increase (causing endotheliumdependent dilatation, EDD). EDD decreased after the menopause in Caucasian women (8.4i2.7 vs 2.7+2.9%,p
The early diastolic notch in the uterine artery Doppler waveform reflects compliance of the vessel wall. This phenomen was investigated in 52 menopausal women without HRT (mean age 53,9; mean LMB 60,3 months) and in 50 with HRT (n:50; mean age 53,4; mean LMB 36,2 months). Scoring system O-4 was established to calculate the notching activity in the uterine artery measured by transvaginal colour Doppler (5-9 MHz, ATL-3000 HDI). The mean notch score was 1,12 in women without HRT and 1,42 for those with HRT. In the subgroups of women without HRT LMB<12 months, I-5 years, 5-10 years, >lO years the notch scores were 1,88, 0,99, 0,52, 0,28, respectively. In women with sequential combined HRT (n:38; mean LMB 36,22 months) mean notch score of 1,58 was found while women taking continuous HRT (n: 12, mean LMB 124,9 months) showed 0,91 score, both are significantly higher when compared to those of the relevant LMB age groups without HRT. The disappearing notch in the menopause suggests decreasing vessel compliance. With HRT the uterine notch persists or reappears even years after the LMB, as a sign of vessel compliance reserve probably activated by oestrogen.
P153
P154
COMPARISON OF THE EFFECTS OF ORAL AND TRANSDERMAL HRT ON PLASMA ENDOTHELIN-1 AND URINARY EXCRETION OF PROSTACYCLIN AND THROMBOXANE METABOLITES.
THE INFLUENCE, OF HRT ON CARDIOVASCUIAR SYSTEM IN POSTMENOPAUSAL WOMEN V.Smethic, N,Klimenchenko, Research Center of Ob/Gyn and Perinatology, Moscow, Russia
0 Ylikorkala, B Cacciatore, Z Paakkari, M J Tikkanen, J Toivonen, Departments of Gynecology, Medicine and Biomedicine, University of Helsinki, Finland Transdermal hormonal replacement therapy (DHRT) has become a popular alternative for oral HRT (OHRT), although it is not known if it provides a equal cardiovascular protection. We compared the effects of sequential OHRT and sequential DHRT on endothelin-1 (ET-l), prostacyclin (PGU) and thromboxane A2 (TxA2). Fortyone postmenopausal women were randomized to statt OHRT (estradiol 2.0 mg in days 1-12, estradiol 2.0 mg + 1.0 mg of norethisterone acetate in days 13-22 and estradiol 1.0 mg in days 2328, Trisekvens@, n=20), or DHRT (50 ug estradiol in days l-28 complemented with 250 pg norethisterone acetate in days 14-28, Estracomb@, n=21) . Plasma levels of ET-1 and urinary output of PG12 metabolite (2,3-dinor-6-keto-PGFla) and that of TxA2 metabolite (2,3-dinor TxB2) were measured before and after 8, 28 and 52 weeks of treatment. The use of DHRT, but not OHRT, was associated with significant reductions in ET-I at 8 and 28 weeks of treatment and in PG12 and in TxA2 at 8 weeks of treatment. Plasma ET-l and ambulatory mean daytime blood pressure as well as PGI2 and TxA2, were in significant linear correlation, but no other relationships between the variables studied were seen. The present study shows the first longterm data that oral and transdermal sequential HRT have relatively small effects on ET-l, PG12 and TxA2. 164
Purnose: To determine the influence of hormone replacement therapy (HRT) on cardiovascular system and lipids of blood in postmenopausal women. Materials 8c Methods: 61 women were investigated with 1 to 10 years postmenopause at the moment of treatment and on HRT background under “Climen” and “Klimonorm” treatment during 12 courses. Echocardiography, electrocardiography analysis of lipids in blood were made every 3 months on therapeutic background. HRT is effective in improving general condition of -Results. women and eliminating subjective cardiac disturbances. The results of cardiography showed improvement in the rate of intracardiac output (CO) and stroke volume (SV), in parameters of myocardial contractivity by 9 months of therapy. On HRT background non-specific changes were manifested less frequently after 9 months of treatment. On the background of “Climen” therapy decrease in cholesterin, LDL, KA was found. In the course of “Klimonorm” treatment decrease in cholesterin, LDL & also in HDL by 12% was seen. Conclusion: HRT is effective in elimination of cardiac disturbances, as shown by the results of echocardiography, electrocardiogram and diminish atherogenic potential of blood.
P152
MENOPAUSE AND IMPAIRED ENDOTHELIAL FUNCTION IN CAUCASIAN BUT NOT IN CHINESE WOMEN.
UTERINE NOTCHING IN THE MENOPAUSE REFLECTS THE ARTERIAL STATUS AND THE ARTERIAL EFFECT OF HRT
JA McCrohon, KS Woo*, JT Robinson, DS Celermajer. Department of Cardiology, University, Hong Kong.
RPAH, Sydney, Australia.
A Jakab Jr, L Ovari, Z Toth, A Balogh,
*The Chinese
Department of Obstetrics and Gynaecology, University Medical School of Debrecen, PO Box 37, H-4012, Debrecen, Hungary
After the menopause, arterial endothelial function (a key event in atherogenesis) becomes progressively impaired in Caucasians. We hypothesised that the menopause-related decrease in endothelial function might be less marked in Chinese women, in whom vascular events are much less common. We studied endothelial function in 20 women (10 aged 20-35 yrs, pre-menopausal; 10 aged 55-66 yrs, post-menopausal) in Southern China, and 20 age-matched Caucasian women in Sydney, Australia. None were taking any cardiac or hormonal therapy. Using ultrasound, brachial artery diameter was measured at rest and after flow increase (causing endotheliumdependent dilatation, EDD). EDD decreased after the menopause in Caucasian women (8.4i2.7 vs 2.7+2.9%,p
The early diastolic notch in the uterine artery Doppler waveform reflects compliance of the vessel wall. This phenomen was investigated in 52 menopausal women without HRT (mean age 53,9; mean LMB 60,3 months) and in 50 with HRT (n:50; mean age 53,4; mean LMB 36,2 months). Scoring system O-4 was established to calculate the notching activity in the uterine artery measured by transvaginal colour Doppler (5-9 MHz, ATL-3000 HDI). The mean notch score was 1,12 in women without HRT and 1,42 for those with HRT. In the subgroups of women without HRT LMB<12 months, I-5 years, 5-10 years, >lO years the notch scores were 1,88, 0,99, 0,52, 0,28, respectively. In women with sequential combined HRT (n:38; mean LMB 36,22 months) mean notch score of 1,58 was found while women taking continuous HRT (n: 12, mean LMB 124,9 months) showed 0,91 score, both are significantly higher when compared to those of the relevant LMB age groups without HRT. The disappearing notch in the menopause suggests decreasing vessel compliance. With HRT the uterine notch persists or reappears even years after the LMB, as a sign of vessel compliance reserve probably activated by oestrogen.
P153
P154
COMPARISON OF THE EFFECTS OF ORAL AND TRANSDERMAL HRT ON PLASMA ENDOTHELIN-1 AND URINARY EXCRETION OF PROSTACYCLIN AND THROMBOXANE METABOLITES.
THE INFLUENCE, OF HRT ON CARDIOVASCUIAR SYSTEM IN POSTMENOPAUSAL WOMEN V.Smethic, N,Klimenchenko, Research Center of Ob/Gyn and Perinatology, Moscow, Russia
0 Ylikorkala, B Cacciatore, Z Paakkari, M J Tikkanen, J Toivonen, Departments of Gynecology, Medicine and Biomedicine, University of Helsinki, Finland Transdermal hormonal replacement therapy (DHRT) has become a popular alternative for oral HRT (OHRT), although it is not known if it provides a equal cardiovascular protection. We compared the effects of sequential OHRT and sequential DHRT on endothelin-1 (ET-l), prostacyclin (PGU) and thromboxane A2 (TxA2). Fortyone postmenopausal women were randomized to statt OHRT (estradiol 2.0 mg in days 1-12, estradiol 2.0 mg + 1.0 mg of norethisterone acetate in days 13-22 and estradiol 1.0 mg in days 2328, Trisekvens@, n=20), or DHRT (50 ug estradiol in days l-28 complemented with 250 pg norethisterone acetate in days 14-28, Estracomb@, n=21) . Plasma levels of ET-1 and urinary output of PG12 metabolite (2,3-dinor-6-keto-PGFla) and that of TxA2 metabolite (2,3-dinor TxB2) were measured before and after 8, 28 and 52 weeks of treatment. The use of DHRT, but not OHRT, was associated with significant reductions in ET-I at 8 and 28 weeks of treatment and in PG12 and in TxA2 at 8 weeks of treatment. Plasma ET-l and ambulatory mean daytime blood pressure as well as PGI2 and TxA2, were in significant linear correlation, but no other relationships between the variables studied were seen. The present study shows the first longterm data that oral and transdermal sequential HRT have relatively small effects on ET-l, PG12 and TxA2. 164
Purnose: To determine the influence of hormone replacement therapy (HRT) on cardiovascular system and lipids of blood in postmenopausal women. Materials 8c Methods: 61 women were investigated with 1 to 10 years postmenopause at the moment of treatment and on HRT background under “Climen” and “Klimonorm” treatment during 12 courses. Echocardiography, electrocardiography analysis of lipids in blood were made every 3 months on therapeutic background. HRT is effective in improving general condition of -Results. women and eliminating subjective cardiac disturbances. The results of cardiography showed improvement in the rate of intracardiac output (CO) and stroke volume (SV), in parameters of myocardial contractivity by 9 months of therapy. On HRT background non-specific changes were manifested less frequently after 9 months of treatment. On the background of “Climen” therapy decrease in cholesterin, LDL, KA was found. In the course of “Klimonorm” treatment decrease in cholesterin, LDL & also in HDL by 12% was seen. Conclusion: HRT is effective in elimination of cardiac disturbances, as shown by the results of echocardiography, electrocardiogram and diminish atherogenic potential of blood.