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Arterial stiffness is not improved in long-term use of estrogen
Kenny A Rodriguez-Macias1, Tord Naessen, Annika Boström
1Departments of Women's and Children's Health, Section for Obstetrics and Gynecology, University Hospital, Uppsala, Sweden.
Insights
Long-term estrogen therapy does not significantly alter arterial stiffness in postmenopausal women. Arterial stiffness increased with age and menopause, regardless of estrogen use.
Area of Science:
- Cardiovascular Science
- Endocrinology
- Gerontology
Background:
- Menopause is associated with increased arterial stiffness.
- Estrogen's role in cardiovascular health is complex and debated.
- Long-term effects of estrogen therapy on vascular aging are not fully understood.
Purpose of the Study:
- To compare arterial stiffness in postmenopausal women using long-term estrogen therapy versus non-users and fertile women.
- To investigate the impact of sustained estrogen exposure on vascular aging.
Main Methods:
- Cross-sectional clinical study.
- Ultrasonic phase-locked echo-tracking used to assess carotid, femoral, and aortic stiffness.
- Compared three groups: long-term estrogen users, age-matched non-users, and fertile women.
Main Results:
- Both postmenopausal groups exhibited significantly higher arterial stiffness compared to fertile women.
- No significant differences in arterial stiffness were found between long-term estrogen users and non-users.
- Adjustments for blood pressure, BMI, and cholesterol did not alter these findings.
Conclusions:
- Long-term estrogen therapy does not substantially mitigate age-related or menopause-related arterial stiffening.
- Arterial stiffening associated with aging and menopause appears independent of long-term estrogen use.
Objective:
The purpose of this study was to compare arterial stiffness in long-term users of estrogen who were postmenopausal, age-matched women who did not use estrogen, and women of fertile age.
Study Design:
In this clinical cross-sectional study, carotid, femoral, and aortic stiffness (estimated as elastic modulus and stiffness beta index) were assessed by ultrasonic phase-locked echo-tracking in 17 women who were postmenopausal and who were treated with 17 beta-estradiol implants (mean age, 68.8 years; mean duration of treatment, 20 years), 17 age-matched (+/-1 year) untreated women, and 20 women in the fertile age period.
Results:
Compared with women of fertile age, both postmenopausal groups had significantly higher stiffness elastic modulus and stiffness beta index (carotid, P <.001; femoral, P <.05; aorta, P <.001). However, for all 3 arteries, both stiffness indices were similar in estrogen users and nonusers and did not differ significantly. These results remained after an adjustment for systolic blood pressure, body mass index, and low-density lipoprotein cholesterol levels.
Conclusion:
These data indicate that the arterial stiffening that is related to aging/menopause is not substantially affected by long-term estrogen therapy.