THE EFFECT OF HORMONE REPLACEMENT THERAPY ON BLOOD-PRESSURE AND CARDIOVASCULAR RISK-FACTORS IN MENOPAUSAL WOMEN WITH MODERATE HYPERTENSION

Objective: To assess the effect of injectable hormone replacement ther apy (HRT) vs a placebo in hypertensive menopausal women. Design and me thods: Prospective randomised double-blind study over 90 days. Fifty-f ive menopausal women with mild to moderate hypertension, stopped their antihypertensive medication and were studied for 2 weeks. Diastolic B P increased to over 105 mm Hg patients who were not included in the st udy. remaining patients were randomly allocated to three groups: place bo (PL), estradiol valeranate 10 mg (E), and estradiol valeranate 4 mg plus prasterone enantate 200 mg (E+P). A further five patients were e xcluded from the study for different reasons. Results: Standing and re cumbent BP decreased in the PL group but did not change in the E and E +P patients. No change was observed in the serum levels of total chole sterol or low density lipoprotein (LDL)-cholesterol at the end of the trial. Plasma renin activity (PRA), aldosterone and insulin levels dec reased during the study; PRA fell more significantly in the E+P group, the aldosterone reduction was highly significant in both hormone trea ted groups, specially the E+P group. Plasma insulin decreased in all g roups and FSH levels were lower in the two treatment groups. Conclusio ns: In a randomised controlled trial no rise in BP was found after 90 days in hypertensive women with two forms of HRT. There was an unexpec ted fall in BP in those women allocated to placebo injections.