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Raloxifene, conjugated oestrogen and endothelial function in postmenopausal women
Author(s) -
Duschek E. J. J.,
Stehouwer C. D. A.,
De ValkDe Roo G. W.,
Schalkwijk C. G.,
Lambert J.,
Netelenbos C.
Publication year - 2003
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.2003.01156.x
Subject(s) - raloxifene , medicine , endothelium , placebo , endocrinology , brachial artery , vasodilation , estrogen , endothelial dysfunction , selective estrogen receptor modulator , urology , estrogen receptor , blood pressure , breast cancer , pathology , cancer , alternative medicine
. Duschek EJJ, Stehouwer CDA, de Valk‐de Roo GW, Schalkwijk CG, Lambert J, Netelenbos C (VU University Medical Center, Amsterdam; Sophia Hospital, Zwolle; The Netherlands). Raloxifene, conjugated oestrogen and endothelial function in postmenopausal women. J Intern Med 2003; 254: 85–94. Objectives. To study the long‐term effects of raloxifene, a potential designer oestrogen, and oestrogen monotherapy on endothelial function in healthy postmenopausal women. Design. A 2‐year double‐blind, randomized and placebo‐controlled study in an Academic Medical Center. Fifty‐six hysterectomized but otherwise healthy postmenopausal women randomly received raloxifene hydrochloride 60 mg day −1 ( n = 15) or 150 mg day −1 ( n = 13), conjugated equine oestrogen (CEE) 0.625 mg day −1 ( n = 15), or placebo ( n = 13). Main outcome measures. Endothelial function as estimated from brachial artery flow‐mediated, endothelium‐dependent vasodilation and nitroglycerine‐induced endothelium‐independent vasodilation, and plasma levels of the endothelium‐derived regulatory proteins, von Willebrand factor (vWF) and endothelin (ET). Results. Raloxifene 60 mg did not significantly affect endothelial function. As compared with placebo, at 6 months of therapy, raloxifene 150 mg and CEE were associated with a mean increase in vWF of 25.5% point (95% CI 3.6–47.3) and 26.6% point (95% CI 6.9–46.3), respectively. At 24 months of therapy, raloxifene 150 mg was associated with a mean decrease in ET of 0.96 pg mL −1 (95% CI −1.57 to −0.36). Raloxifene nor CEE significantly affected endothelium‐dependent and/or ‐independent vasodilation. Conclusions. Our results suggest that long‐term therapy with raloxifene or oral CEE does not affect endothelium‐dependent vasodilation in healthy postmenopausal women. Raloxifene 150 mg day −1 might have both positive and negative effects on endothelium. The clinical significance of these findings remains to be investigated.