Hemorheological aspects in hypertensive menopausal smoker women treated with female hormones

In postmenopausal hypertensive women (PostMHW) the erythrocyte deformabilit y (ED) is reduced if compared with premenopausal hypertensive women (PreMHW ). This might partially explain the increased incidence of cardiovascular d iseases (CD) in hypertensive women after menopause. Moreover a positive correlation exists between estradiol and rheological pa tterns in women. If PostMHW smoke cigarettes, there is an important decreas e in hemorheological parameters. On the other hand if PostMHW are submitted to an hormonal replacement therapy (HRT) they can show controversial resul ts with an impairment if hemorheological parameters. The aim of this study was to evaluate the influence of smoking and HRT on PostMHW. We studied fou r groups of subjects: Group 1: PreMHW (10 F aged 35 +/- 3 years) non smoker s; Group 2: PostMHW (8 F aged 45 +/- 2 years) non smokers; Group 3: PostMHW (14 F aged 48 +/- 4 years) smokers (20 cigarettes per day); Group 4: PostM HW (16 F aged 50 +/- 2 years) smokers (20 cigarettes per day) submitted to HRT. We evaluated Elongation Index of erythrocytes under torsion force of 3 0 pascals (EI - 30 Pa) using a new computerized instrument Laser assisted O ptical rotational Red Cell Analyzer (LORCA) (Mechatronics, Hoorn, NL) acc. to Hardeman (1994) and, also with the same LORCA, Aggregation Index (AI), t 1/2. We measured the transcutaneous oxygen partial pressure (TcpO(2)) in su bclavicular standard area using a Transcutaneous Oximeter (Microgas 7650 Ko ntron Instruments with Combi Sensor) and total cholesterolaemia. In PostMHW our data showed a significant (p < 0.01) impairment of hemorheol ogical patterns and tissue oxygenation if compared with PreMHW (Group 1). I n Group 3 there is a significant (p < 0.01) decrease in EI, a significant ( p < 0.01) increase in AI, a significant (p < 0.01) decrease in t1/2 and Tcp O(2) if compared with Control Group 1 and Group 2. Finally a further signif icant (p < 0.01) impairment in hemorheology and tissue oxygenation showed G roup 4. In conclusion, it seems necessary, that many studies will be performed to u nderstand really protective action of HRT on cardiovascular diseases in Pos tMHW and it is necessary to suppress cigarette smoking to prevent cardiovas cular complications in these patients.