Embargoed until Monday March 1912 a.m. ET
Hormone replacement best for blood pressure if taken within five years of menopause
By STEVEN BARAGONAUNC-CH School of Medicine
EMBARGOED CHAPEL HILL-Hormone replacement therapy may be most effective in lowering the risk of hypertensive heart disease if begun in the first five years after menopause, according to a new study. The heart condition is tied to high blood pressure.
The study by researchers at the University of North Carolina at Chapel Hill School of Medicine found that hormone replacement therapy reduced blood pressure in women who had been thorough menopause less than five years prior to treatment. But those who received the treatment more than five years after menopause showed a much smaller blood pressure reduction.
Kimberly Brownley, Ph.D., Research Assistant Professor in the Department of Psychiatry at UNC's Stress and Health Research Program will present the new findings at the American College of Cardiology's annual conference in Orlando, Florida, Monday March 19.
Brownley's study is the first to examine if a link exists between time since menopause and the effect on blood pressure of hormone replacement therapy. Previous studies of hormone replacement therapy showed little or no beneficial effects on blood pressure. But a woman's time beyond menopause was not specifically considered.
Previous studies have shown that estrogen therapy reduces "bad" (LDL) cholesterol, but such changes do not confer direct benefits in reducing atherosclerosis in women with pre-existing coronary heart disease. According to Brownley, it may be important to re-evaluate these findings while taking into consideration time since menopause.
"Instead of concluding that estrogen does not influence the process of atherosclerosis in women who already have coronary heart disease," she said, "we might come up with a little bit different twist on things. It might be that, yes it does have a positive effect, but only if you get treated within a shorter window of time."
Brownley and her co-workers studied a group of 69 women, including those who went through menopause less than five years before entering the study, and women who were more than five years postmenopausal. For six months the women in each group were randomized to receive either hormone replacement therapy or placebo. Their blood pressure was measured while resting and during experimental conditions of mild stress, such as describing an anger-provoking event.
The researchers also examined cholesterol levels in the two groups of women, and found that hormone replacement raised levels of "good" (HDL) cholesterol in both groups. Time since menopause did not appear to affect this benefit of hormone replacement therapy.
"I think the take-home message is that time since menopause may be an important variable to consider when evaluating the efficacy of hormone replacement therapy in the primary prevention of hypertensive heart disease among postmenopausal women," Brownley said.
Brownley's UNC collaborators were Susan S. Girdler, PhD, Alan L. Hinderliter, MD, Kathleen C. Light, PhD, and Karen M. Grewen, MA. This study was supported by a grant from the National Heart, Lung and Blood Institute and Wyeth-Ayerst.
--30--
Media note: Contact Drs. Brownley or Light at 919-966-2544; [email protected] or [email protected]School of Medicine contact: Leslie H. Lang, 919-843-9687; [email protected]
RSS