Blood Pressure Predicts Endothelial Function and Effect of Ethinyl Estradiol in Young Obese and Lean Women

Abstract

Obesity, mild hypertension and endothelial function are all predictors of cardiovascular disease in women, and we propose that these factors are interrelated. We hypothesized that obesity and high blood pressure are associated with endothelial dysfunction in young women. Further, we hypothesized that short‐term low‐dose ethinyl estradiol treatment would mitigate this dysfunction. We examined hyperemic responses before and during 30 μg/day oral ethinyl estradiol (EE) treatment for 7 days in 16 healthy women (mean 26 ± 5, 19–35 yrs) with normal (NBP; n=7, MAP range: 78–91 mmHg) or mildly elevated blood pressure (HBP; n=9, MAP range: 95–113 mmHg). We evaluated brachial vasodilatory responses following two stimuli designed to elicit different levels of shear stress: 5‐min occlusion (RH‐FMD), and 3‐min occlusion with ischemic handgrip exercise (IE‐FMD). Body composition did not impact RH‐FMD or IE‐FMD responses. In contrast, Pre‐EE, HBP had lower IE‐FMD responses relative to NBP (8.0 ± 3.5% vs. 12.3 ± 3.2%, respectively; P=0.05). During EE, IE‐FMD increased in HBP (12.8 ± 6.1%; P=0.02) and decreased in NBP (5.6 ± 2.4%, P<0.01). The increase in shear stress (8659 ± 4964 vs. 14753 ± 8189 AUC, s−1; P=0.04) contributed to the increase in IE‐FMD in HBP subjects during EE, while shear stress did not change with EE in NBP (9740 ± 3222 vs. 10564 ± 2984 AUC, s−1; P=0.76). MAP did not predict RH‐FMD responses or associated shear stress, pre‐or during‐EE. Thus, 1) in young healthy women, moderately elevated blood pressure was a predictor of endothelial function whereas obesity was not; 2) EE mitigated endothelial dysfunction associated with elevated blood pressure; 3) the enhanced shear stress stimulus was able to subtle differences in endothelial function where the standard FMD stimulus did not. Because HBP women had only mildly high blood pressure, these data are of particular significance given the new American Heart Association guidelines for hypertension.Support or Funding InformationSupported by the APS Undergraduate Research Excellence Fellowship; the Paul Titus Fellowship Fund, Dept. Obstetrics Gynecology and Reproductive Sciences, Yale School of Medicine; and the AHA Postdoctoral Fellowship.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.