Kawecka-Jaszcz Kalina, Czarnecka Danuta, Dembińska-Kieć Aldona, Olszanecka Agnieszka, Zdzienicka Anna
I Cardiac Department, Jagiellonian University, Medical College, Kraków, Poland.
Blood Press. 2002;11(1):28-34. doi: 10.1080/080370502753543936.
Hypertension, hyperinsulinaemia and dyslipidaemia are strong and independent risk factors for cardiovascular diseases. Their increasing frequency in postmenopausal women suggests that oestrogen deficiency may be a contributing factor. It is well known that oestrogen replacement therapy in postmenopausal women improves carbohydrate and lipid metabolism, but the effect of combined hormone replacement therapy (HRT) remains unclear. The purpose of the present study was to evaluate the effect of HRT on blood pressure, carbohydrate metabolism and lipid profile in postmenopausal women with primary arterial hypertension. The study population consisted of 76 postmenopausal women (mean age 51.1 +/- 6.8 years). Forty hypertensive women received HRT (17-beta-oestradiol, norethisterone acetate, TTS, Estracomb Novartis), whereas 36 women remained without hormonal therapy. One-year combined transdermal HRT did not affect significantly blood pressure and blood pressure variability. HRT was shown to improve lipid profile with a significant decrease in total cholesterol as early as at 3 months. It does not influence carbohydrate metabolism parameters studied by glycaemia and insulinaemia in a standard oral glucose tolerance test. In conclusion, combined percutaneous HRT may reduce the lipid-depended cardiovascular risk in postmenopausal women with arterial hypertension.
高血压、高胰岛素血症和血脂异常是心血管疾病的重要独立危险因素。它们在绝经后女性中的发病率不断上升，提示雌激素缺乏可能是一个促成因素。众所周知，绝经后女性的雌激素替代疗法可改善碳水化合物和脂质代谢，但联合激素替代疗法（HRT）的效果仍不明确。本研究的目的是评估HRT对绝经后原发性动脉高血压女性血压、碳水化合物代谢和血脂谱的影响。研究人群包括76名绝经后女性（平均年龄51.1 +/- 6.8岁）。40名高血压女性接受了HRT（17-β-雌二醇、醋酸炔诺酮、经皮贴剂、诺华公司的Estracomb），而36名女性未接受激素治疗。为期一年的联合经皮HRT对血压和血压变异性无显著影响。HRT显示可改善血脂谱，早在3个月时总胆固醇就显著降低。在标准口服葡萄糖耐量试验中，它不影响通过血糖和胰岛素血症研究的碳水化合物代谢参数。总之，联合经皮HRT可能会降低绝经后动脉高血压女性的脂质相关心血管风险。
