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Related Experiment Videos

Endothelin levels decrease after oral and nonoral estrogen in postmenopausal women with increased cardiovascular risk

J G Wilcox1, I E Hatch, E Gentzschein

  • 1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.

Fertility and Sterility
|February 1, 1997
PubMed
Summary

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Postmenopausal women have higher plasma endothelin-1 levels, a risk factor for cardiovascular disease. Estrogen replacement therapy, particularly transdermal E2, significantly reduced these levels, suggesting a cardioprotective mechanism.

Area of Science:

  • Cardiovascular endocrinology
  • Reproductive endocrinology

Background:

  • Elevated plasma endothelin-1 (ET-1) is associated with increased cardiovascular (CV) risk.
  • Postmenopausal women, especially those with CV risk factors like hypertension and hypercholesterolemia, may have altered ET-1 levels.
  • Estrogen replacement therapy (ERT) is known to have cardiovascular effects, but the specific impact on ET-1 requires further elucidation.

Purpose of the Study:

  • To compare plasma endothelin-1 levels between premenopausal women and postmenopausal women with increased CV risk.
  • To investigate the effects of different forms of estrogen replacement therapy on plasma endothelin-1 levels in postmenopausal women.

Main Methods:

  • A prospective randomized study was conducted involving 18 postmenopausal women (mean age 53.4 years) with hypercholesterolemia (total cholesterol > 240 mg/dL) and 10 healthy premenopausal women.

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  • Postmenopausal women were randomized to receive oral estrone sulfate, transdermal estradiol (E2), or placebo for 30 days.
  • Plasma endothelin-1 and total cholesterol levels were measured at baseline and after 30 days of treatment.

    • Main Results:

    • Postmenopausal women exhibited significantly higher plasma endothelin-1 levels (4.58 pg/mL) compared to premenopausal women (2.80 pg/mL).
    • Hypertensive postmenopausal women had even higher endothelin-1 levels (5.56 pg/mL).
    • Estrogen replacement therapy (oral estrone sulfate and transdermal E2) led to a statistically significant decrease in plasma endothelin-1 levels, with the greatest reduction observed in hypertensive women receiving estrogen therapy (18.4% decrease). Transdermal E2 showed a notable reduction.
    • Baseline plasma endothelin-1 levels were positively correlated with plasma cholesterol levels (r=0.632).

    Conclusions:

    • Postmenopausal status and increased cardiovascular risk factors are associated with elevated plasma endothelin-1.
    • Estrogen replacement therapy, particularly transdermal E2, effectively reduces plasma endothelin-1 levels in postmenopausal women.
    • These findings suggest a potential mechanism through which hormone replacement therapy may exert cardioprotective effects by modulating endothelin-1.