This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Increases in the stiffness of arteries located throughout the body are associated with a higher risk for heart disease. After menopause, women have a higher risk for cardiovascular disease possibly due to the loss of estrogen. The increased risk for cardiovascular disease may be due, in part, to the increase in the stiffness of the arteries. Hormone replacement therapy (HRT) and regular exercise have been shown to be associated with a lower risk for cardiovascular disease, and may be producing their protective effects through favorable effects on the walls of the artery. The proposed protocol will determine the effects of three different types of HRT and the combined effects of HRT and exercise on improving the stiffness of arteries located in your neck (carotid), as well as on improving the function of your heart and nervous system. Postmenopausal women will be randomly assigned to one of four groups: conjugated estrogen, oral estradiol, estrogen patch, or placebo (no medication). After 3 months, the women will be placed on a home-based endurance-exercise program consisting moderate intensity walking for 40-45 minutes a day, 5-7 days per week. The women will continue to take their HRT while participating in the 3 month walking program. Ultrasound images of the carotid artery and heart will be measured at the beginning of the study and after 6 months of the therapy. The primary outcome of the study will be to determine whether women taking HRT and/or exercise demonstrate an improvement in the stiffness or their arteries.
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