Transdermal HRT and Doppler findings in normotensive and hypertensive postmenopausal patients

Objective To evaluate the effects of transdermal hormone replacement therapy (HRT) on plasma viscosity, serum levels of thromboxane B 2 (TXB 2 ) and vascular impedance in the uterine, bladder wall, internal carotid and ophthalmic arteries in normotensive and hypertensive postmenopausal patients. Methods Thirty postmenopausal patients underwent continuous estradiol transdermal supplementation at a dose of 50 µg/day and 12‐day courses of medroxyprogesterone acetate 10 mg/day every 2 months. The women were divided into two groups according to their blood pressure: normotensive women (Group 1, n = 14) and hypertensive subjects (Group 2, n = 16). Before starting HRT and after 6 months of therapy, the patients underwent: transvaginal ultrasonographic examination of the pelvic organs; Doppler examination of the blood flow velocities in the uterine, bladder wall, internal carotid and ophthalmic arteries; and analysis of plasma viscosity and plasma TXB 2 . Results After 6 months of HRT plasma viscosity had decreased in both groups (mean reduction in Group 1, (14 ± 1)%, P = 0.005; mean reduction in Group 2, (10 ± 1)%, P = 0.005) as had the TXB 2 levels (mean reduction in Group 1, (93 ± 2)%, P < 0.001; mean reduction in Group 2, (92 ± 3)%, P < 0.001). The mean percentage reduction in plasma viscosity was smaller in hypertensive women than in normotensive women ( P < 0.05). There was also a significant reduction in vascular impedance in the uterine artery (mean reduction in Group 1, (16 ± 1)%, P = 0.005; mean reduction in Group 2, (19 ± 1)%, P = 0.005), the bladder wall arteries (mean reduction in Group 1, (23 ± 2)%, P = 0.005; mean reduction in Group 2, (18 ± 1)%, P = 0.005), the internal carotid artery (mean reduction in Group 1, (25 ± 1)%, P = 0.005; mean reduction in Group 2, (26 ± 1)%, P = 0.005) and the ophthalmic artery (mean reduction in Group 1, (24 ± 2)%, P = 0.005; mean reduction in Group 2, (16 ± 1)%, P = 0.005). The percentage reduction in vascular impedance did not differ significantly between the two groups. Conclusions Our results show that transdermal HRT is effective in reducing plasma viscosity, TXB 2 levels and vascular impedance in the peripheral and central vessels both in normotensive and hypertensive postmenopausal patients. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.