Key result
Transdermal 17beta-estradiol improved flow-mediated dilation compared with placebo in postmenopausal women in their fifties (7.69% vs 4.81%, P<0.05), but not in older women.
Why the study?
Does transdermal 17beta-estradiol improve flow-mediated dilation in postmenopausal women aged 50 to 80 years?
RCT (n=100)
Double-blind
Crossover
Does transdermal 17beta-estradiol improve flow-mediated dilation in postmenopausal women aged 50 to 80 years?
Transdermal 17beta-estradiol improves endothelial function only in early postmenopausal women (fifties), suggesting age moderates the cardiovascular effects of hormone replacement therapy.
Supports age-specific HRT consideration in early postmenopause; extends evidence that timing moderates vascular effects.
OBJECTIVE: We evaluated age and coronary heart disease (CHD) as potential moderators of the effects of 17beta-estradiol on vascular endothelial function in postmenopausal women. METHODS AND RESULTS: In a double-blind crossover design, 100 postmenopausal women aged 50 to 80 years were randomized to each of 3 transdermal patches, releasing 17beta-estradiol (0.05 mg/d), 17beta-estradiol (0.05 mg/d) + norethindrone acetate (NETA, 0.14 mg/d), and placebo. Flow-mediated dilation (FMD) and response to 400 microg sublingual glyceryl trinitrate (GTN-D) were assessed approximately 18 hours after patch placement. Age, but not CHD, moderated the FMD response to treatment (P=0.01). For women in their fifties, the estradiol patch was associated with improved FMD (7.69+/-4.79%) compared with placebo (4.81+/-5.97%, P<0.05), but the estradiol+norethindrone patch response (5.81+/-4.85%) was not significantly different from placebo. Women in their sixties and seventies showed no alterations in FMD response to either active patch. GTN-D response declined with advancing age (P<0.01), with women in their seventies exhibiting blunted GTN-D response compared with younger women. CONCLUSIONS: The cardiovascular benefits of natural estrogen supplementation on vascular endothelial function may be dependent on postmenopausal age, with improved vascular function evident only in the early postmenopausal years. Short-term FMD response to estradiol might help stratify individual differences in risks versus benefits of HRT.
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Sherwood et al. (2007) conducted an RCT in Postmenopausal (n=100). Transdermal 17beta-estradiol with or without norethindrone acetate vs. Placebo was evaluated on Flow-mediated dilation (FMD) (p=<0.05). Transdermal 17beta-estradiol improved flow-mediated dilation compared with placebo in postmenopausal women in their fifties (7.69% vs 4.81%, P<0.05), but not in older women.
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