Document Detail

Effect of hot flushes on cardiovascular autonomic responsiveness: a randomized controlled trial on hormone therapy.
MedLine Citation:
PMID:  22537767     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare the responses of heart rate and blood pressure to various autonomic tests in women with and without pre-treatment hot flushes during estradiol and estradiol+medroxyprogesterone acetate (MPA) use.
STUDY DESIGN AND MAIN OUTCOME MEASURES: Hundred and fifty recently postmenopausal women (72 with and 78 without hot flushes) were randomized to receive transdermal estradiol (1mg/day), oral estradiol (2 mg/day) alone or in combination with MPA (5mg/day), or placebo for six months. Cardiovascular responsiveness was comprehensively assessed with controlled and deep breathing, active orthostatic test, Valsalva maneuver and handgrip test.
RESULTS: Hot flushes were accompanied with a significant reduction (-2.2±0.7 vs. 1.3±1.1 beats/min, p=0.03) in resting heart rate during estradiol-only treatment; the route of estradiol administration was no factor in this regard. This effect was attenuated by the addition of MPA to oral estradiol. Hot flushes were also associated with reduced maximal heart rate in response to handgrip during the use of estradiol-only therapy (-2.2±1.3 vs. 2.8±1.5 beats/min, p=0.038); again, the MPA addition eliminated this effect. Hot flushes were accompanied with lowered resting but augmented blood pressure responses to handgrip test during all hormone regimens, whereas in women without hot flushes estradiol-only regimen tended to elevate diastolic resting blood pressure.
CONCLUSIONS: Hot flushes appear as determinants for cardiovascular responses to hormone therapy. Estradiol-only therapy causes beneficial changes in cardiovascular regulation in flushing women, and these are blunted, in part, by the addition of MPA.
Hanna Hautamäki; Petri Haapalahti; Päivi Piirilä; Pauliina Tuomikoski; Anssi Sovijärvi; Olavi Ylikorkala; Tomi S Mikkola
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-04-24
Journal Detail:
Title:  Maturitas     Volume:  72     ISSN:  1873-4111     ISO Abbreviation:  Maturitas     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-04     Completed Date:  2012-10-04     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7807333     Medline TA:  Maturitas     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  243-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
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MeSH Terms
Autonomic Nervous System / drug effects*,  physiopathology
Blood Pressure / drug effects*,  physiology
Contraceptive Agents, Female / pharmacology
Estradiol / pharmacology,  therapeutic use*
Estrogen Replacement Therapy*
Estrogens / pharmacology,  therapeutic use*
Hand Strength
Heart Rate / drug effects*,  physiology
Hot Flashes / drug therapy*,  physiopathology
Medroxyprogesterone Acetate / pharmacology
Middle Aged
Physical Exertion / physiology
Postmenopause / physiology
Reference Values
Reg. No./Substance:
0/Contraceptive Agents, Female; 0/Estrogens; 50-28-2/Estradiol; 71-58-9/Medroxyprogesterone Acetate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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