Document Detail

Pulse pressure and coronary atherosclerosis progression in postmenopausal women.
MedLine Citation:
PMID:  15545509     Owner:  NLM     Status:  MEDLINE    
Pulse pressure, an index of large artery stiffness, has been associated with coronary events. However, mechanisms for this association remain unclear. In this study, we examined the relationship between pulse pressure and the progression of coronary atherosclerosis and the effects of hormone replacement therapy (HRT) on pulse pressure in postmenopausal women with angiographically confirmed coronary disease followed for 3.2 years in the Estrogen Replacement in Atherosclerosis (ERA) trial. In the ERA trial, 309 postmenopausal women (mean age 66+/-7 years) with coronary disease were randomized to estrogen, estrogen plus progestin, or placebo, and followed for 3.2 years. Ten standardized epicardial segments were measured for minimal diameter values at baseline and follow-up using quantitative coronary angiography. For this study, mixed-model analysis of covariance was used to: (1) test the association between pulse pressure and change in mean minimum diameter (MMD) adjusted for baseline MMD and (2) the effect of HRT on follow-up pulse pressure. After adjustment for potential confounders, there was a significant graded increase in progression of coronary stenosis with increasing quartiles of baseline pulse pressure (P test for trend=0.0001). The progression rate in women with the highest quartile of baseline pulse pressure was 5-fold higher than in women in the lowest quartile (P<0.01). In postmenopausal women with coronary disease, increased levels of baseline pulse pressure are associated with subsequent progression of coronary atherosclerosis in postmenopausal women. HRT had no detectable effect on pulse pressure.
Girish V Nair; David Waters; William Rogers; Glen J Kowalchuk; Thomas D Stuckey; David M Herrington
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2004-11-15
Journal Detail:
Title:  Hypertension     Volume:  45     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-31     Completed Date:  2005-07-12     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-7     Citation Subset:  IM    
Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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MeSH Terms
Blood Pressure* / drug effects
Coronary Angiography
Coronary Artery Disease / epidemiology*,  physiopathology,  radiography
Disease Progression
Estrogen Replacement Therapy
Estrogens, Conjugated (USP) / pharmacology
Follow-Up Studies
Hormone Replacement Therapy
Medroxyprogesterone Acetate / pharmacology
Middle Aged
Single-Blind Method
Vascular Resistance
Grant Support
HL 45488/HL/NHLBI NIH HHS; M01-07122//PHS HHS
Reg. No./Substance:
0/Estrogens, Conjugated (USP); 71-58-9/Medroxyprogesterone Acetate

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

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