Insulin resistance and lipids in hypertensive women on hormone replacement therapy

Hypertension, hyperinsulinaemia and dyslipidaemia are strong and independent risk factors for cardiovascular diseases. Their increasing frequency in postmenopausal women suggests that oestrogen deficiency may be a contributing factor. It is well known that oestrogen replacement therapy in postmenopausal women improves carbohydrate and lipid metabolism, but the effect of combined hormone replacement therapy (HRT) remains unclear. The purpose of the present study was to evaluate the effect of HRT on blood pressure, carbohydrate metabolism and lipid profile in postmenopausal women with primary arterial hypertension. The study population consisted of 76 postmenopausal women (mean age 51.1 +/- 6.8 years). Forty hypertensive women received HRT (17-beta-oestradiol, norethisterone acetate, TTS, Estracomb Novartis), whereas 36 women remained without hormonal therapy. One-year combined transdermal HRT did not affect significantly blood pressure and blood pressure variability. HRT was shown to improve lipid profile with a significant decrease in total cholesterol as early as at 3 months. It does not influence carbohydrate metabolism parameters studied by glycaemia and insulinaemia in a standard oral glucose tolerance test. In conclusion, combined percutaneous HRT may reduce the lipid-depended cardiovascular risk in postmenopausal women with arterial hypertension.