Key result
Hormone replacement therapy linked to reduced left ventricular mass index and RAAS activity in postmenopausal hypertension.
Observational (n=21)
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Demonstrates that hormone replacement therapy reduces left ventricular mass in hypertensive postmenopausal women, suggesting cardiac remodeling independent of blood pressure changes.
We investigated the effects of hormone replacement therapy (HRT) on left ventricular hypertrophy (LVH) and growth-promoting factors in hypertensive postmenopausal women (PMW) with LVH. Twenty-one Japanese hypertensive PMW (age 55.3+/-0.8 years) with LVH who had never received HRT volunteered to participate in this study. Eleven subjects received a daily dose of HRT (0.625 mg conjugated equine estrogen, 2.5 mg medroxyprogesterone acetate) orally for 12 months. Ten PMW who refused HRT were enrolled as controls. Blood pressure and serum angiotensin-converting enzyme (ACE) activity, plasma aldosterone, and insulin resistance were measured. M-mode echocardiography and blood pressure measurements were performed in all patients. Data obtained before and after 12 months of HRT were compared. No significant differences in blood pressure were observed between the two groups after 12 months of HRT. In the HRT group, the LV mass index (p<0.01), serum ACE activity (p<0.01), and plasma aldosterone (p<0.01) levels were reduced after 12 months of treatment. The changes in serum ACE activity and plasma aldosterone were not correlated with the change in LV mass index in the HRT group. No significant changes in blood pressure, LV mass index, serum ACE activity, plasma aldosterone, or insulin resistance were observed in the control group. HRT contributed to the reduction of LV mass in hypertensive PMW. However, the effect of HRT on LVH did not appear to be associated with changes in growth-promoting factors, such as blood pressure, serum ACE activity, plasma aldosterone, and insulin resistance.
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Miya et al. (2002) conducted an observational in Hypertension with left ventricular hypertrophy in postmenopausal women (n=21). Hormone replacement therapy (conjugated equine estrogen and medroxyprogesterone acetate) vs. No hormone replacement therapy (refused treatment) was evaluated on Left ventricular mass index, serum ACE activity, and plasma aldosterone levels (p=<0.01). Hormone replacement therapy for 12 months reduced left ventricular mass index, serum ACE activity, and plasma aldosterone in hypertensive postmenopausal women.
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