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Venous endothelial function in postmenopausal women who are receiving long-term estrogen and progestagen therapy
C Ceballos1, C Ribes, J A Amado
1Department of Gynecology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain.
Objective:
To test venous endothelial function during long-term hormone replacement therapy (HRT) and after treatment withdrawal.
Design:
Measurement of dorsal hand-vein diameter by venous occlusion plethysmography during infusion of norepinephrine, bradykinin, NG-monomethyl L-arginine, and sodium nitroprusside.
Setting:
Plethysmography and menopause units, University Hospital Marqués de Valdecilla, Santander, Spain.
Patient(S):
Twenty postmenopausal women, of whom 10 were assigned to receive no hormone replacement therapy (HRT) for 6 months after plethysmography (group A) and 10 were assigned to receive HRT for 6 months (group B). After 6 months, HRT was administered to group A and withdrawn from group B for another 6 months.
Intervention(S):
Plethysmography at baseline and at 6 and 12 months.
Main Outcome Measure(S):
Dorsal hand-vein diameter measured by venous occlusion plethysmography during infusion of norepinephrine, bradykinin, NG-monomethyl L-arginine, or sodium nitroprusside.
Result(S):
At 6 months, the maximum dilation obtained with bradykinin was 48.8 +/- 7.58% in group A and 76.7 +/- 12.9% in group B. At 12 months, maximum bradykinin dilation increased to 74.3 +/- 14.2% in group A and decreased to 54.0 +/- 15.9% in group B.
Conclusion(S):
Long-term HRT with estrogen plus progestin improves endothelium-dependent vasodilation, but this effect is lost in a relatively short time. Endothelial function in dorsal hand veins is an easy-to-use plethysmography model that can be used in serial studies.