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Hormone replacement therapy and serum angiotensin-converting-enzyme activity in postmenopausal women
A J Proudler1, A I Ahmed, D Crook
1Wynn Department of Metabolic Medicine, National Heart and Lung Institute, London, UK.
Insights
Hormone replacement therapy (HRT) significantly lowers angiotensin-converting-enzyme (ACE) activity in postmenopausal women. This reduction in ACE activity may be a new way HRT helps decrease coronary heart disease (CHD) risk.
Area of Science:
- Cardiovascular Endocrinology
- Pharmacology
- Menopause Research
Background:
- Mechanisms of hormone replacement therapy (HRT) in reducing coronary heart disease (CHD) risk are not fully understood.
- Direct arterial effects are a potential pathway for HRT's cardioprotective benefits.
Purpose of the Study:
- To investigate the impact of oestrogen/progestagen HRT on serum angiotensin-converting-enzyme (ACE) activity.
- To explore potential novel mechanisms linking HRT to reduced CHD risk in postmenopausal women.
Main Methods:
- A study involving postmenopausal women receiving oestrogen/progestagen HRT.
- Measurement of serum ACE activity before and after 6 months of HRT.
- Comparison with a control group of women not receiving HRT.
Main Results:
- Serum ACE activity decreased by an average of 20% in the HRT group (p < 0.001).
- No significant change in serum ACE activity was observed in the control group.
- ACE activity was found to be modifiable by gonadal steroids.
Conclusions:
- Serum ACE activity is influenced by gonadal steroids in postmenopausal women.
- Reduced serum ACE activity represents a potential novel mechanism for HRT's cardioprotective effects.
- HRT may reduce CHD risk through modulation of the renin-angiotensin system.
Abstract:
The mechanisms by which hormone replacement therapy (HRT) reduces the risk of coronary heart disease (CHD) are incompletely understood, but may include direct arterial effects. We examined the effect of oestrogen/progestagen HRT on serum angiotensin-converting-enzyme (ACE) activity in postmenopausal women. After 6 months, ACE activity was reduced by 20% (p < 0.001) on average in 28 treated women but remained unchanged in 16 controls. Serum ACE activity is modifiable by gonadal steroids and changes in serum ACE may represent a novel mechanism by which HRT reduces CHD risk in women.