Postmenopausal use of estrogen replacement therapy substantially reduces risk of coronary mortality at an age when untreated women show accelerated risk increases. This investigation is designed to evaluate the biobehavioral basis for this estrogen-related decrease in coronary risk, and to assess comparative benefits associated with estrogen use along, versus estrogen plus progesterone, versus placebo after 3 months and 6 months of treatment. This study will focus on possible changes in left ventricular structure and function which may result from reduced total peripheral resistance (TPR). The study sample will consist of 75 postmenopausal women aged 40-59. Fifty women will receive estrogen alone for 3 months, then half will continue with estrogen alone while the other half receives estrogen plus progesterone for the second 3 months. Finally, 25 women will receive only placebos for the full 6 months. Measures obtained at initial testing, retesting and final testing include: a) 24-hour ambulatory blood pressure; b) Doppler-validated, impedance-derived estimates of stroke volume, cardiac output and TPR as well as blood pressure at rest and after mental stressors; c) plasma beta-endorphin levels and responsivity to standardized pain tests, as well as pain threshold and tolerance measures; d) Doppler and echocardiographic measures of left ventricular mass index, relative wall thickness, contractility and arterial compliance. The following are the primary hypotheses to be tested: 1) Compared to placebo, treatment with estrogen alone is associated with lower 24-hour blood pressure, lowered TPR at rest and during stressors, included beta-endorphin responsivity, and better arterial compliance and left ventricular structure and function; 2) The addition of progesterone to estrogen results in less significant improvement in these measures compared to continuation of estrogen alone.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL050778-01
Application #
2227066
Study Section
Special Emphasis Panel (ZHL1-CSR-P (S2))
Project Start
1994-03-01
Project End
1998-02-28
Budget Start
1994-03-01
Budget End
1995-02-28
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Psychiatry
Type
Schools of Medicine
DUNS #
078861598
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Light, Kathleen C; Grewen, Karen M; Amico, Janet A et al. (2005) Oxytocinergic activity is linked to lower blood pressure and vascular resistance during stress in postmenopausal women on estrogen replacement. Horm Behav 47:540-8
Brownley, Kimberly A; Hinderliter, Alan L; West, Sheila G et al. (2004) Cardiovascular effects of 6 months of hormone replacement therapy versus placebo: differences associated with years since menopause. Am J Obstet Gynecol 190:1052-8
Light, K C; Hinderliter, A L; West, S G et al. (2001) Hormone replacement improves hemodynamic profile and left ventricular geometry in hypertensive and normotensive postmenopausal women. J Hypertens 19:269-78
Meyer, W R; Costello, N; Straneva, P et al. (2001) Effect of low-dose estrogen on hemodynamic response to stress. Fertil Steril 75:394-9
West, S G; Hinderliter, A L; Wells, E C et al. (2001) Transdermal estrogen reduces vascular resistance and serum cholesterol in postmenopausal women. Am J Obstet Gynecol 184:926-33
Girdler, S S; Hinderliter, A L; West, S G et al. (2000) Postmenopausal smokers show reduced hemodynamic benefit from oral hormone replacement. Am J Cardiol 86:590-2, A10
Girdler, S S; O'Briant, C; Steege, J et al. (1999) A comparison of the effect of estrogen with or without progesterone on mood and physical symptoms in postmenopausal women. J Womens Health Gend Based Med 8:637-46
West, S G; Light, K C; Hinderliter, A L et al. (1999) Potassium supplementation induces beneficial cardiovascular changes during rest and stress in salt sensitive individuals. Health Psychol 18:229-40
West, S G; Brownley, K A; Light, K C (1998) Postexercise vasodilatation reduces diastolic blood pressure responses to stress. Ann Behav Med 20:77-83
Brownley, K A; West, S G; Hinderliter, A L et al. (1996) Acute aerobic exercise reduces ambulatory blood pressure in borderline hypertensive men and women. Am J Hypertens 9:200-6

Showing the most recent 10 out of 11 publications