1085 Effects of hormone replacement therapy containing drospirenone on blood pressure and anthropometry in postmenopausal hypertensive women with abdominal obesity

Abstract

Introduction: Decrease level of sex steroids and relative aldosteronism possibly contribute to metabolic disorders of postmenopause. Drospirenone is a new synthetic progestin with potent antimineralocorticoid activity. Study Objective: To evaluate the effects of hormone replacement therapy (HRT) (estradiol hemihydrate 1 mg, drospirenone 2 mg daily) on blood pressure and abdominal obesity in postmenopausal women. Material and Methods: 63 postmenopausal women with newly diagnosed essential hypertension grades 1-2 (mean blood pressure 154.5 ± 5.1/95.5 ± 1.2 mm Hg) were examined. The patients had abdominal obesity (wais circumference 101.3 ± 3.1 cm, body mass index 31.8 ± 2.1). All patient received treatment with angiotensin receptor blocker Telmisartan 40 mg daily. In 1 month they were randomized into 2 groups. Group 1 (n = 30) continued treatment with Telmisartan. In group 2 (n = 33) HRT was added. Results: Telmisartan therapy led to BP decrease in all patients. In 68.7% (n = 44) target levels of BP were achieved after 4 weeks (to 124.7 ± 3.8/83.7 ± 1.6 mm Hg, p ≤ 0.05). In 24 of 33 patients receiving HRT further decrease in BP levels was observed (to 115.7 ± 4.2/77.5 ± 2.2 mm Hg, p ≤ 0.05). The rest of the patients have normalized BP by increasing the dose of Telmisartan. In the majority of patients receiving HRT: BMI decreased to 28.2 kg/m2 vs 30.1 kg/m2 (p ≤ 0.05), waist circumference to hip circumference ratio decreased to 0.90 ± 0.02 vs 0.92 ± 0.06 (p ≤ 0.05). In group 2 no changes were seen. Conclusion: Hormone replacement therapy with estradiol hemihydrate and drospirenone lead to blood pressure lowering and to decrease of severity of abdominal obesity.