December 1, 2001Arteriosclerosis Thrombosis and Vascular Biology
Estrogen Replacement and Brachial Artery Flow-Mediated Vasodilation in Older Women
Why the study?
Does estrogen replacement therapy improve brachial artery flow-mediated vasodilation in older postmenopausal women?
Population
1,662 older postmenopausal women over 65 years of age with or at risk for coronary heart disease from the…
Comparison
Estrogen replacement therapy vs Nonusers of estrogen replacement therapy
Design
Cohort
Follow-up
10 years (tenth annual examination)
Authors
Discussion
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Implication
Estrogen therapy was not linked to better endothelial function overall; hypothesis-generating for benefit limited to women without cardiovascular disease or risk factors.
Key Points
- To evaluate whether estrogen replacement therapy improves endothelial function, measured by brachial artery flow-mediated vasodilation, in older postmenopausal women with or without cardiovascular disease.
- Analyzed cross-sectional follow-up data from the longitudinal Cardiovascular Health Study among postmenopausal women aged 65 years and older (N=1,662).
- Assessed brachial artery flow-mediated vasodilation via ultrasound in response to hyperemic flow across 1,636 women, comparing hormone therapy users (n=291; 75.9% unopposed estrogen) with nonusers after adjusting for confounders.
- Overall flow-mediated vasodilator responses did not differ significantly between estrogen users and nonusers after multivariable adjustment, with the lack of effect most evident in women over 80 and those with established cardiovascular disease.
- A significant positive association between hormone replacement therapy and flow-mediated vasodilation occurred exclusively among women without clinical or subclinical cardiovascular disease or cardiovascular risk factors (P=0.01).
Structured PICO
Does estrogen replacement therapy improve brachial artery flow-mediated vasodilation in older postmenopausal women?
P
Population
1,662 older postmenopausal women over 65 years of age with or at risk for coronary heart disease from the Cardiovascular Health Study
I
Intervention
Estrogen replacement therapy (with or without progestin)
C
Comparator
Nonusers of estrogen replacement therapy
O
Outcome
Brachial artery flow-mediated vasodilation in response to a flow stimulus (hyperemia)surrogate
Estrogen replacement therapy does not improve endothelial function in older postmenopausal women overall, but may have favorable vascular effects in those who have not yet developed atherosclerotic vascular disease.
Cite This Study
Herrington et al. (2001) studied this question.