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WS17‐01Hormone replacement therapy reduces impedance to flow in different vascular beds
Author(s) -
Van Baal W. M.,
Kenemans P.,
Stehouwer C. D. A.,
Van Vugt J. M. G.,
Van Der Mooren M. J.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00009-1-109.x
Subject(s) - medicine , dydrogesterone , uterine artery , menopause , retinal , central retinal artery , artery , pulsatility index , urology , cardiology , estrogen , blood flow , gynecology , pregnancy , ophthalmology , fetus , gestation , biology , genetics
An HRT‐associated reduction of the pulsatility index (PI) has been reported in the literature, although cross‐sectional studies have shown conflicting data. In a prospective, controlled study we randomized 30 healthy postmenopausal women (mean age 52 ± 3 years) into two groups. Women in the HRT group (N = 15) received 1 mg micronized 17β‐estradiol daily (E2) sequentially combined with 5 or 10 mg dydrogesterone for 14 days of each 28‐day cycle during 12 months, and, thereafter, 2 mg E2 combined with 10 mg dydrogesterone for a period of 3 months. The control group (N = 15) received no treatment. Color Doppler ultrasound was used to measure the impedance to flow (pulsatility index [PI]) within the uterine, central retinal and ophthalmic arteries in the E2‐phase at baseline and after 3, 12 and 15 months. Compared to controls, 12 months of HRT was associated with a significant decrease in the mean PI of the uterine artery of −39% (HRT −25%, controls +14%) and in that of the central retinal artery of −29% (HRT −9%, controls +20%). After 3 months this effect was already evident. During HRT, the reductions in mean PI of the uterine and central retinal arteries vs. baseline were larger (both P = 0.002) in the women with high pretreatment PI values when compared to those with low pretreatment values. The baseline PI of the uterine artery correlated positively with age and with duration of amenorrhoea ( r = 0.42, P = 0.01 and r = 0.48, P = 0.008, respectively). Our 12‐month study expanded on earlier reports of a reduced PI of the uterine artery. We used a combined regimen containing a low‐dose of oestrogens. These results are important because the recent trend is to recommend combined HRT that contain lower dosages of oestrogens than before. Furthermore, a 29% reduction of the PI of the central retinal artery was observed, which suggests that HRT has a positive influence on the impedance of the cerebral circulation. From the point of view of atherothrombotic risk these observations are beneficial and possibly helpful in understanding the decreased risk of cardiovascular disease, and of the impairment of cognitive functions associated with oestrogens in epidemiological data.