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Impact of hormone replacement therapy on microvascular function in healthy and Type 2 diabetic postmenopausal women
Author(s) -
Gooding K. M.,
MacLeod K. M.,
Spyer G.,
Ewings P.,
Tooke J. E.,
Shore A. C.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01456.x
Subject(s) - medicine , hormone replacement therapy (female to male) , postmenopausal women , hormone therapy , estrogen replacement therapy , type 2 diabetes , endocrinology , diabetes mellitus , gynecology , cancer , testosterone (patch) , breast cancer
Aims Hormone replacement therapy (HRT) has been previously reported to modulate vascular function and cardiovascular risk. Its impact on the macrocirculation has previously been explored, however, little data is available on its impact on the microcirculation. This study aimed to determine the impact of HRT on microvascular function in healthy and Type 2 diabetic postmenopausal women ( n = 20 and 17, respectively). Methods Microvascular function was assessed by skin maximum hyperaemia, skin hyperaemic response to iontophoretically applied acetylcholine (endothelial‐dependent vasodilator) and sodium nitroprusside (endothelial‐independent vasodilator), capillary pressure and the microvascular filtration capacity. Microvascular assessments were carried out at baseline and repeated following 6 months’ oral hormone replacement therapy (1 mg oestradiol/0.5 mg norethisterone or 1 mg unopposed oestradiol for hysterectomized women). Results Following 6 months’ therapy there were no significant changes in microvascular assessments in the healthy women. In the diabetic women there was a reduction in the skin hyperaemic response to acetylcholine [median pretreatment peak response: 1.95 (25th, 75th centiles: 1.54, 2.30) V vs. post‐treatment peak response: 1.53 (1.30, 1.91) V ( P = 0.011, Wilcoxon's signed rank test)] and sodium nitroprusside [median peak response 1.59 (1.37, 1.99) vs. 1.35 (0.92, 1.63) V ( P = 0.011)] with HRT, but no other changes. Conclusion These data suggests that HRT does not affect microvascular function in healthy women, but adversely affects it in diabetic women. These findings may help to explain why HRT fails to provide the predicted cardiovascular protection, and raises the possibility that HRT influences microangiopathy progression in diabetic women.