Double-blind randomized placebo-controlled study of transdermal estrogen replacement therapy on hypertensive postmenopausal women

We investigated the effects of transdermal 17 beta-estradiol, combined with standard antihypertensive therapy, on the modification of the cardiovascul ar risk profile in hypertensive postmenopausal women. In a randomized, doub le-blind, placebo-controlled study, we enrolled 200 postmenopausal women wi th mild to moderate hypertension. Patients received 17 beta-estradiol (50 m u g/day, transdermal) and norethisterone acetate (2.5 mg/day, orally) or pl acebo. At baseline serum total cholesterol, LDL cholesterol, HDL cholestero l, triglycerides, glucose, and fibrinogen plasma levels were measured and a ll subjects underwent complete M-mode and 2-D echocardiograms, which were r epeated after 6, 12 and 18 months of hormonal replacement therapy. Compared with. placebo, all values decreased significantly except for HDL cholester ol. In both groups, no modifications were observed in echocardiographic par ameters, except for left ventricular mean diastolic and systolic wall thick ness and left ventricular mass index, which showed a significant decrease i n both groups. The reduction was greater in the treated group; the percenta ge of patients with left ventricular hypertrophy was 46% before randomizati on and 17.2% after 18 months of treatment (P < .0001), whereas in group II the percentage was 48% at baseline and 31.5% after 18 months (P < .05). In conclusion transdermal 17 beta-estradiol, associated with antihypertensi ve therapy,may contribute to the reduction of cardiovascular risk profile i n hypertensive postmenopausal women. (C) 1999 American Journal of Hypertens ion, Ltd.