Effects of transdermal 17 beta-estradiol on left ventricular anatomy and performance in hypertensive women

To reduce cardiovascular complications, antihypertensive therapy should not only normalize blood pressure but also induce a regression of structural a bnormalities, which are the expression of end-organ damage. We investigated the effects of transdermal 17 beta-estradiol, combined with standard antih ypertensive therapy, on the modification of left ventricular anatomy and sy stolic performance in hypertensive postmenopausal women. In a randomized, d ouble-blind, placebo-controlled study, we enrolled 169 postmenopausal women with mild or moderate hypertension. Eighty-six patients (group 1) received transdermal 17 beta-estradiol (50 mu g/d) and norethisterone acetate (2.5 mg/d, orally), and 83 patients (group 2) received placebo. At baseline, all women underwent M-mode and 2-D echocardiogram, which was repeated after 6, 12, and 18 months of follow-up. After 18 months of treatment, we observed a significant decrease in left ventricular diastolic septal and posterior w all thickness and mass in both groups. Furthermore, after 18 months, left v entricular mass was significantly less than in the estrogen-treated group. No significant modifications were observed in left ventricular systolic and diastolic dimensions or in systolic performance, as expressed by left vent ricular fractional shortening. In conclusion, transdermal 17 beta-estradiol , which is associated with antihypertensive therapy, may contribute in the reduction of left ventricular mass in hypertensive postmenopausal women.