(Hypertension. 1999;34:1041-1046.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Effects of Transdermal 17ß-Estradiol on Left Ventricular Anatomy and Performance in Hypertensive Women
From the Institute of Cardiology II, Department of Internal Medicine, University of Modena, Italy.
Correspondence to Maria Grazia Modena, MD, FESC, FACC, Institute of Cardiology II, Policlinico Hospital, Via del Pozzo, 71, 41100 Modena, Italy. E-mail modena.m{at}policlinico.mo.it
Abstract—To reduce cardiovascular complications, antihypertensive therapy should not only normalize blood pressure but also induce a regression of structural abnormalities, which are the expression of end-organ damage. We investigated the effects of transdermal 17ß-estradiol, combined with standard antihypertensive therapy, on the modification of left ventricular anatomy and systolic performance in hypertensive postmenopausal women. In a randomized, double-blind, placebo-controlled study, we enrolled 169 postmenopausal women with mild or moderate hypertension. Eighty-six patients (group 1) received transdermal 17ß-estradiol (50 µg/d) and norethisterone acetate (2.5 mg/d, orally), and 83 patients (group 2) received placebo. At baseline, all women underwent M-mode and 2-D echocardiogram, which was repeated after 6, 12, and 18 months of follow-up. After 18 months of treatment, we observed a significant decrease in left ventricular diastolic septal and posterior wall thickness and mass in both groups. Furthermore, after 18 months, left ventricular mass was significantly less than in the estrogen-treated group. No significant modifications were observed in left ventricular systolic and diastolic dimensions or in systolic performance, as expressed by left ventricular fractional shortening. In conclusion, transdermal 17ß-estradiol, which is associated with antihypertensive therapy, may contribute in the reduction of left ventricular mass in hypertensive postmenopausal women.
Key Words: hypertension, mild • hypertrophy • trials • drugs • estrogen • menopause • echocardiography
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