Document Detail


Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women.
MedLine Citation:
PMID:  15846267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Both exercise and postmenopausal estrogen therapy augment endothelial function. We hypothesized that their interaction would be additive. The study objectives were to determine in postmenopausal women (1) the effects of an acute bout of exercise on brachial artery endothelium-dependent flow-mediated vasodilation (FMD), (2) whether these responses to exercise are augmented by concurrent estrogen treatment, and (3) whether these 2 interventions, independently or together, achieve FMD values observed in premenopausal women. METHODS: In postmenopausal women (n = 13; age 54 +/- 2 [mean +/- SE] years), FMD was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes at 60% V* O2max. Subjects were studied twice: before and after 4 weeks of oral estradiol. To obtain reference normal values, FMD was determined concurrently in 14 premenopausal (28 +/- 1 years) women under identical basal conditions. RESULTS: Flow-mediated vasodilation in postmenopausal women, markedly impaired when compared with premenopausal women (5.3% +/- 0.5% vs 12.1% +/- 1.5%, P < .01), was significantly increased by exercise (to 9.9% +/- 0.6%, P < .01). In contrast, after estrogen, FMD was augmented at rest (P < .01) but was not further enhanced after exercise (11.5% +/- 0.6% vs 9.9% +/- 0.5%, P = .3). Both interventions increased, independently, FMD to values in premenopausal women (P > .05). CONCLUSIONS: In postmenopausal women, both acute exercise and estrogen therapy normalize FMD. However, their effects are not additive, possibly because of redundancy of nitric oxide signaling pathways activated by these 2 interventions. When considered in the context of recent trials with adverse cardiovascular outcomes, these results reinforce the therapeutic potential of exercise as an alternative nonpharmacological intervention to estrogen in postmenopausal women with endothelial dysfunction.
Authors:
Paula J Harvey; Peter E Picton; Winnie S Su; Beverley L Morris; Catherine F Notarius; John S Floras
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  149     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-04-22     Completed Date:  2005-09-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  291-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada. paula.harvey@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Blood Pressure
Brachial Artery / drug effects,  physiology
Cholesterol / blood
Endothelium, Vascular / drug effects,  physiology*
Estradiol / blood,  pharmacology*
Estrogen Replacement Therapy*
Exercise / physiology*
Female
Heart Rate
Humans
Middle Aged
Nitric Oxide / physiology
Postmenopause / drug effects,  physiology*
Triglycerides / blood
Vasodilation / drug effects,  physiology*
Chemical
Reg. No./Substance:
0/Triglycerides; 10102-43-9/Nitric Oxide; 50-28-2/Estradiol; 57-88-5/Cholesterol

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


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