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Exp Clin Endocrinol Diabetes 2003; 111(5): 267-273
DOI: 10.1055/s-2003-41753
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

One Year Follow-Up of Hormone Replacement Therapy with Percutaneous Estradiol and Low-Dose Vaginal Natural Progesterone in Women with Mild to Moderate Hypertension

P. M. Spritzer 1 , 2 , D. Vitola 3 , L. C. Vilodre 1 , 2 , M. C. O. Wender 1 , F. M. Reis 4 , S. Ruschel 1 , I. Castro 3
  • 1Gynecological Endocrinology Unit, Division of Endocrinology, University Hospital, Brazil
  • 2Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
  • 3Cardiology Institut, Porto Alegre, Brazil
  • 4Medical School of Barbacena, Brazil (formerly at Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil)
Further Information

Publication History

Received: May 16, 2002 First decision: July 18, 2002

Accepted: January 10, 2003

Publication Date:
02 September 2003 (online)

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Abstract

Objective

The effects of natural estradiol and progesterone replacement therapy on lipoprotein and cardiovascular parameters were assessed in 20 postmenopausal women with mild to moderate systemic arterial hypertension.

Design

After confirming hypertension in the absence of antihypertensive treatment, blood pressure control was achieved by administration of amlodipine at individually adjusted doses. Hormone replacement therapy (HRT) was introduced in a cyclic regimen (21 of 28 days) with percutaneous estradiol (1.5 mg/day) and vaginal micronized progesterone (100 mg/day).

Results

Blood pressure and mean heart rate remained unchanged during HRT. Serial echocardiograph scans showed no change in left ventricle mass, but a significant reduction in the thickness of the left ventricular posterior wall was observed. During treatment, patients showed little variation in total cholesterol levels (baseline: 199 ± 10 mg/dl, 12 months: 202 ± 11 mg/dl), as well as in high-density lipoprotein (53 ± 2 to 50 ± 3 mg/dl), low-density lipoprotein (122 ± 10 to 118 ± 11 mg/dl), and triglycerides (111 ± 13 to 126 ± 13 mg/dl). A subgroup of 10 patients with initial total cholesterol levels > 200 mg/dl responded to HRT with a slight but significant decrease of cholesterol levels after 12 months (265 ± 10 to 237 ± 12 mg/dl, p < 0.05, repeated measures ANOVA). HRT did not change mean antithrombin III levels and affected neither plasma renin activity nor aldosterone levels.

Conclusion

These results suggest that the proposed HRT regimen with percutaneous estradiol associated with low-dose vaginal micronized progesterone could be a safe alternative for postmenopausal women with hypertension at least during the period required to treat menopausal symptoms.

Key words

Progesterone - menopause - HRT - cutaneous administration - lipoproteins

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M. D., PhD Poli Mara Spritzer

Department of Physiology
Universidade Federal do Rio Grande do Sul

Rua Sarmento Leite, 500

90050-170 Porto Alegre, RS

Brazil

Phone: + 555133163671

Fax: + 55 51 33 16 31 66

Email: spritzer@vortex.ufrgs.br

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