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Autonomic and cardiovascular function in postmenopausal women: the effects of estrogen versus combination therapy
Noha H Farag1, Richard A Nelesen, Barbara L Parry
1Department of Psychiatry, University of California, San Diego, UCSD Medical Center, 92103-0804, USA. nfarag@ucsd.edu
Objective:
This study examined the effects of oral estrogen (ERT) alone versus oral estrogen/medroxyprogesterone acetate (HRT) therapy on cardiovascular function, as controlled by the autonomic nervous system.
Study Design:
Forty-three postmenopausal women received ERT, HRT, or a placebo for 3 months in a double-blind, randomized, placebo-controlled study. Cardiovascular hemodynamics and heart rate variability were assessed at rest and during stress.
Results:
After 3 months of therapy, oral HRT significantly increased high-frequency power (P =.0002) and decreased total peripheral resistance (P =.04). The changes were evident at rest and during stress.
Conclusion:
Our findings suggest that combination therapy produces a more favorable alteration of autonomic cardiovascular function than estrogen alone (ie, combination therapy increases vagal activity).