EXERCISE ECHOCARDIOGRAPHY IN POSTMENOPAUSAL HORMONE USERS WITH MILD SYSTEMIC HYPERTENSION

Rest and exercise echocardiography (at dynamic and isometric exercise) were performed in 30 postmenopausal women (aged 54+/-4 years) with bo rderline to mild hypertension. They were then divided into 2 groups: 1 7 women who started oral hormone replacement therapy (0.625 mg/day con jugated estrogens or 2 mg/day estradiol) and a control group of 13 non users. After 6 to 9 months, a second echocardiography was performed in 26 women (4 withdrew). There were only a few changes in values obtain ed in the 12 controls at the end of follow-vp compared with baseline. Primarily, these changes included a slight decrease in systolic blood pressure at rest and on exercise. Several significant morphologic and hemodynamic alterations appeared in 14 hormone users. Left ventricular cavity dimensions and mass became smaller: mean end-diastolic diamete r decreased from 45.9+/-3 mm at baseline to 44.4+/-3 mm at study termi nation (p=0.007). The corresponding values for end-systolic diameter w ere 25.8+/-4 mm and 23.9+/-4 mm (p=0.006); for left atrium diameter, i t was 34.5+/-4 mm and 32.5+/-4 mm (p= 0.001); for left ventricular wal l width, it was 19.9+/-2 mm and 19.3+/-2 mm (p=0.02); for left ventric ular mass, it was 197+/-28 g and 179+/-32 g (p=0.006). The resting aor tic blood flow velocity and acceleration increased: 119+/-18 cm/s befo re therapy versus 129+/- 23 cm/s while on hormone substitution (p=0.04 ), and 13.6+/-3 m/s(2) versus 16.5+/-4 m/s(2) (p=0.008), respectively. Mean rest to peak exercise systolic blood pressure difference became smaller after hormones: 39 +/-19 mm Hg versus 28+/-13 mm Hg (p=0.03) d uring dynamic exercise, and 43+/-22 mm Hg versus 25+/-13 mm Hg (p=0.00 4) during isometric exercise. The above data probably indicate that wi th hormone replacement therapy, there is an improvement in cardiac fun ction both at rest and during exercise. (C) 1996 by Excerpta Medica, I nc.