Portal de Periódicos da CAPES

Effect of medroxyprogesterone acetate plus estradiol on endothelium-dependent vasodilation in postmenopausal women

2001; Elsevier BV; Volume: 87; Issue: 2 Linguagem: Inglês

10.1016/s0002-9149(00)01329-1

1879-1913

Hiroaki Kawano, Takeshi Motoyama, Nobutaka Hirai, Toshihiro Yoshimura, Kiyotaka Kugiyama, Hisao Ogawa, Hitoshi Okamura, Hirofumi Yasue,

Endometriosis Research and Treatment

Estrogen replacement therapy reduces risk of cardiovascular events 1 Witteman J.C.M Grobbee D.E Kok F.J Hofman A Valkenburg H.A Increased risk of atherosclerosis in women after the menopause. BMJ. 1989; 298: 642-644 Crossref PubMed Scopus (231) Google Scholar , 2 Samaan S.A Crawford M.H Estrogen and cardiovascular function after menopause. J Am Coll Cardiol. 1995; 26: 1403-1410 Abstract Full Text PDF PubMed Scopus (99) Google Scholar , 3 Belchetz P.E Hormone treatment of postmenopausal women. N Engl J Med. 1994; 330: 1062-1071 Crossref PubMed Scopus (385) Google Scholar , 4 Stampfer M.J Colditz G.A Willett W.C Manson J.E Rosner B Speizer F.E Hennekens C.H Postmenopausal estrogen therapy and cardiovascular disease. N Engl J Med. 1991; 325: 756-762 Crossref PubMed Scopus (2013) Google Scholar , 5 Grodstein F Stampfer M.J Manson J.E Colditz G.A Willett W.C Rosner B Speizer F.E Hennekens C.H Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med. 1996; 335: 435-461 Crossref Scopus (1303) Google Scholar and is required by a great number of postmenopausal women. Because the addition of progestins had been demonstrated to remove the risk of endometrial cancer induced by long-term use of estrogen, 3 Belchetz P.E Hormone treatment of postmenopausal women. N Engl J Med. 1994; 330: 1062-1071 Crossref PubMed Scopus (385) Google Scholar , 6 Grady D Rubin S.M Petitti D.B Fox C.S Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992; 117: 1016-1037 Crossref PubMed Scopus (2210) Google Scholar estrogen plus progestin treatment has become the most utilized therapy today. The effect of progestins, however, still remains controversial. Some investigators have reported that progestin does not affect the risk of coronary artery disease, 1 Witteman J.C.M Grobbee D.E Kok F.J Hofman A Valkenburg H.A Increased risk of atherosclerosis in women after the menopause. BMJ. 1989; 298: 642-644 Crossref PubMed Scopus (231) Google Scholar , 3 Belchetz P.E Hormone treatment of postmenopausal women. N Engl J Med. 1994; 330: 1062-1071 Crossref PubMed Scopus (385) Google Scholar , 4 Stampfer M.J Colditz G.A Willett W.C Manson J.E Rosner B Speizer F.E Hennekens C.H Postmenopausal estrogen therapy and cardiovascular disease. N Engl J Med. 1991; 325: 756-762 Crossref PubMed Scopus (2013) Google Scholar , 5 Grodstein F Stampfer M.J Manson J.E Colditz G.A Willett W.C Rosner B Speizer F.E Hennekens C.H Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med. 1996; 335: 435-461 Crossref Scopus (1303) Google Scholar whereas others have reported that it increases the risk. 3 Belchetz P.E Hormone treatment of postmenopausal women. N Engl J Med. 1994; 330: 1062-1071 Crossref PubMed Scopus (385) Google Scholar , 7 Hulley S Grady D Bush T Furberg C Herrington D Riggs B Vittinghoff E Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA. 1998; 280: 605-613 Crossref PubMed Scopus (5773) Google Scholar , 8 Miller V.T Muesing R.A LaRosa J.C Stoy D.B Phillips E.A Stillman R.J Effects of conjugated equine estrogen with and without ferent progesterones on lipoproteins, high-density lipoprotein subfractions, and apolipoprotein A-I. Obstet Gynecol. 1991; 77: 235-240 Crossref PubMed Scopus (119) Google Scholar , 9 Barrett-Connor E Bush T.L Estrogen and coronary heart disease in women. JAMA. 1991; 265: 1861-1867 Crossref PubMed Scopus (1228) Google Scholar Recently, noninvasive examination of endothelial function has become possible by measuring flow-mediated dilation of the brachial artery during reactive hyperemia after transient occlusion. 10 Kawano H Motoyama T Kugiyama K Hirashima O Ohgushi M Fujii H Ogawa H Yasue H Gender difference in improvement of endothelium-dependent vasodilation after estrogen supplementation. J Am Coll Cardiol. 1997; 30: 914-919 Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar , 11 Gerhard M Walsh B.W Tawakol A Haley E.A Creager S.J Seely E.W Ganz P Creager M.A Estradiol therapy combined with progesterone and endothelium-dependent vasodilation in postmenopausal women. Circulation. 1998; 98: 1158-1163 Crossref PubMed Scopus (300) Google Scholar , 12 Kawano H Motoyama T Kugiyama K Hirashima O Ohgushi M Yoshimura M Ogawa H Okumura K Yasue H Menstrual cyclic variation of endothelium-dependent vasodilation of the brachial artery. Proc Assoc Am Physicians. 1996; 108: 473-480 PubMed Google Scholar , 13 Motoyama T Kawano H Kugiyama K Hirashima O Ohgushi M Tsunoda R Moriyama Y Miyao Y Yoshimura M Ogawa H Yasue H Vitamin E administration improves impairment of endothelium-dependent vasodilation in patients with coronary spastic angina. J Am Coll Cardiol. 1998; 32: 1672-1679 Abstract Full Text Full Text PDF PubMed Scopus (158) Google Scholar , 14 Anderson T.J Uehata A Gerhard M.D Meredith I.T Knab S Delagrange D Lieberman E.H Ganz P Creager M.A Yeung A.C Selwyn A.P Close relation of endothelial function in human coronary and peripheral circulations. J Am Coll Cardiol. 1995; 26: 1235-1241 Abstract Full Text PDF PubMed Scopus (1785) Google Scholar The objective of the present study was to determine the effects of medroxyprogesterone acetate (MPA), a progestin widely used and believed to be highly successful when added to estrogen replacement therapy, on endothelial function in postmenopausal women.