Cardiovascular Disease In Postmenopausal Women Research Articles

Conjugated equine estrogen treatment corrected the exacerbated aorta oxidative stress in ovariectomized spontaneously hypertensive rats

ObjectiveThe increased risk of cardiovascular diseases in postmenopausal women has been linked to the decrease in plasma estrogen levels. Preparation of conjugate equine estrogens (CEE) is one of the most routinely used hormone therapy in postmenopausal women. However, studies on the vascular effects of CEE are still sparse and the mechanism of action is not completely elucidated. In this context, we have determined the effects of CEE in the vascular oxidative stress observed in ovariectomyzed (OVX) spontaneously hypertensive rats (SHR). Mechanisms by which CEE interferes with redox-sensitive pathways and endothelial function were also determined. ResultsAortas from OVX rats exhibited increased generation of reactive oxygen species (ROS), NADPH oxidase activity and reduced catalase protein expression, compared to aortas from sham SHR. Endothelium-intact aortic rings from OVX were hyperreactive to NE when compared to Sham aortas. This hyperreactivity was corrected by superoxide dismutase (SOD), catalase, and endothelium removal. Treatment of OVX-SHR with CEE reduced vascular ROS generation, NADPH oxidase activity, enhanced SOD and catalase expression and also corrected the NE-hyperreactivity in aortic rings from OVX-SHR. ConclusionOur study indicates a potential benefit of CEE therapy through a mechanism that involves reduction in oxidative stress, improving endothelial function in OVX hypertensive rats.

Hysterectomy is associated with large artery stiffening in estrogen-deficient postmenopausal women

Hysterectomy, with or without oophorectomy, is associated with increased cardiovascular disease (CVD) risk due, in part, to an adverse CVD risk factor profile. Large artery stiffening, a biomarker of vascular aging, increases the risk for CVD. We determined whether hysterectomy with or without bilateral oophorectomy (BLO) is associated with arterial stiffening in healthy postmenopausal women. We conducted a cross-sectional study including estrogen-deficient postmenopausal women who had a hysterectomy with ovarian preservation (n = 24; mean ± SE age, 59 ± 1 y) or with BLO (n = 21; 58 ± 2 y) and had no hysterectomy/no BLO (n = 58; 58 ± 1 y). Arterial stiffness (arterial compliance and β stiffness index) was measured by ultrasonography of the carotid artery. Carotid artery compliance was lower in women with hysterectomy alone and in women with hysterectomy with BLO compared with women with no hysterectomy (0.66 ± 0.03 and 0.71 ± 0.06 vs 0.89 ± 0.03 mm/mm Hg × 10, respectively, both P < 0.05). There were no differences in traditional CVD risk factors (ie, adiposity, blood pressure and fasted lipids and lipoproteins, glucose, and insulin) between the groups. After adjustment for age, menopause duration, previous menopausal hormone therapy duration, parity, waist-to-hip ratio, systolic blood pressure, and sex hormone-binding globulin, hysterectomy status remained a significant predictor of arterial compliance. These results indicate that hysterectomy status (with or without BLO) is associated with greater arterial stiffening in estrogen-deficient postmenopausal women. The greater arterial stiffening with hysterectomy was not related to an adverse CVD risk profile. Large artery stiffening may be an important mechanism by which hysterectomy increases the risk of CVD in postmenopausal women.

Effects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women

The aim of this study was to evaluate the effects of red ginseng (RG) on menopausal symptoms and cardiovascular risk factors in postmenopausal women. A randomized, placebo-controlled, double-blind clinical trial was conducted with postmenopausal women between the ages of 45 and 60 years. A total of 72 women were randomly assigned to either an RG group (supplemented with 3 g of RG, including 60 mg of ginsenosides, per day) or a placebo group for 12 weeks. We analyzed changes in menopausal symptoms (the Kupperman index and the menopause rating scale), cardiovascular risk factors (lipid profiles, high-sensitivity C-reactive protein, and carotid intima-media thickness), and serum estradiol levels from baseline to 12 weeks. Significant improvements in the Kupperman index (P = 0.032) and in the menopause rating scale (P = 0.035) scores were observed in the RG group compared with the placebo group. Total cholesterol (P = 0.009) and low-density lipoprotein cholesterol (P = 0.015) significantly decreased in the group receiving RG. The RG group also showed a significant decrease in carotid intima-media thickness (P = 0.049). Serum estradiol levels were not influenced by RG supplementation. RG could be an attractive herbal dietary supplement for relieving menopausal symptoms and conferring favorable effects on markers of cardiovascular disease in postmenopausal women.

Effects of Isoflavones Supplements and Exercise on Biomarkers of CVD in Korean Postmenopausal Women

The objective of this study was to assess the combined effects of isoflavones supplements (70 mg/d of isoflavones) and exercise (81 min/day) in Korean postmenopausal women. We recruited postmenopausal women who were free of diagnosed cardiovascular disease (KMC IRB 1002‐02). In this double‐blind randomized controlled trial, 67 postmenopausal women were assigned to four groups: 1. Placebo (PLA, n=9) 2. Isoflavone supplements (ISO, n=11), 3. Exercise and placebo (Ex+PLA, n=25), 4. Exercise and isoflavone supplements (Ex+ISO, n=22). Dietary isoflavones intakes were analyzed by a 3‐day food records. Blood levels of lipids, insulin, glucose, hormones, hs‐CRP, sVCAM, and sI‐CAM were analyzed at baseline and 12 weeks. The average age and menopausal period were not different among the groups. The levels of total and LDL‐chol in the PLA were significantly higher than in the ISO, Ex+PLA, and Ex+ISO groups (p&lt;.05). Levels of hs‐CRP, sICAM‐1 and sVCAM‐1 were not different among the groups. However, sICAM‐1 levels increased after supplementation, in the Ex+ISO group and sVCAM‐1 levels reduced after supplementation, in the ISO group (p&lt;.05). In conclusion, isoflavone supplements and exercise for 12 weeks prevented the increased levels of blood total‐ and LDL‐cholesterol, however further study is to confirm the beneficial effects on cardiovascular disease in postmenopausal women.

Combined effects of exercise and soy isoflavone diet on paraoxonase, nitric oxide and aortic apoptosis in ovariectomized rats

Menopause is associated with an increased risk of cardiovascular disease (CVD). Exercise and soy isoflavone diets have been suggested to reduce the risk of CVD in postmenopausal women. We investigated the effects of exercise, or combined exercise and soy isoflavone diet, on plasma lipid profiles, paraoxonase (PON), nitric oxide (NO) and apoptosis in the aorta of ovariectomized (OVX) rats. Thirty-two female Sprague–Dawley rats were divided into four groups: OVX with general diet (OVX-GD), OVX with isoflavone diet (OVX-ISO), OVX-GD with exercise training (OVX-ET) and OVX-ISO with exercise training (OVX-ISO+ET). The experimental rats undertook treadmill training (30min/day, 4days/week) and/or were supplied a soy isoflavone diet (added to the experimental diet at 2.39mg/g protein) for 12weeks. Body weight and levels of total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C) increased in the OVX rats and HDL-C decreased. These effects were reduced by exercise and/or soy isoflavone supplementation. PON and NO activities were higher in the OVX-ISO+ET group than in the OVX-GD group. In addition, this group had lower caspase-9 and -3 and higher Bcl-2 expression, and there was less aortic apoptotic cell death. These results suggest that a combination of exercise and a soy isoflavone diet has beneficial effects in terms of protecting against cardiovascular risk factors by controlling lipid profiles and the related enzyme, PON, as well as NO activity and apoptosis of the aorta in OVX rats.

Menopausal symptoms and risk factors for cardiovascular disease in postmenopause

ABSTRACTObjectives Conflicting evidence indicates an increased risk for cardiovascular disease in postmenopausal women suffering from hot flushes. In this study, we tested whether, beyond hot flushes, menopausal symptoms are associated with biochemical and biophysical risk factors for cardiovascular disease.Methods Retrospective cross-sectional analysis on 951 women in surgical or physiological postmenopause, recruited at the menopause outpatient service of our university hospital between April 2002 and December 2009. The Greene Climacteric Scale and its subscales for anxiety, depression, somatic symptoms, vasomotor symptoms and sexuality were used to evaluate menopausal complaints. Blood pressure, fasting glucose and lipids levels were evaluated as risk factors for cardiovascular disease. Anthropometric parameters and those derived by remote and reproductive medical history were used as possible confounders. All data were anonymously retrieved from an electronic database.Results By multiple regression analysis, high density lipoprotein (HDL) cholesterol was inversely related to body mass index, the Greene Climacteric Scale score and years since menopause (R = 0.390; p = 0.0001). The total cholesterol/HDL cholesterol ratio was positively related to waist circumference and the Greene Climacteric Scale score (R = 0.356; p = 0.0001). Triglycerides (R = 0.353; p = 0.0001) and triglyceride/HDL cholesterol (R = 0.425; p = 0.0001) were positively related to waist circumference, the Greene Climacteric Scale score and the Greene vasomotor subscore. Glucose was positively related to waist circumference, years since menopause and the Greene Climacteric Scale score (R = 0.390; p = 0.0001). Blood pressure was not related to menopausal symptoms. The 10-year risk for cardiovascular disease calculated by the Framingham formula was related independently and directly to body mass index and the Greene Climacteric Scale score (R = 0.183; p = 0.0001).Conclusions Menopausal symptoms evaluated by a validated climacteric scale are associated with a worsening of biochemical risk factors for atherosclerosis and cardiovascular disease.

Reproductive risk factors for cardiovascular disease mortality among postmenopausal women in Korea

The relationship between reproductive factors and the risk of mortality from cardiovascular disease in postmenopausal women is unclear. In this study, we aimed to investigate this relationship in Korean postmenopausal women. Subcohort analysis was carried out using the data of 3,257 postmenopausal women (age, ≥55 y at study entry) from the Kangwha Cohort Study who were followed up from 1985 until 2005. Cox proportional hazards models were used to evaluate the associations between reproductive factors and cardiovascular disease mortality. The risk of cardiovascular mortality in women who were 20 to 22 years old at first childbirth was 26% lower (95% CI, 0.60-0.92) than that in women younger than 20 years at first childbirth, after adjustment for age at entry, body mass index, hypertension, drinking, smoking, education, and occupation. Early first childbirth was associated with increased cardiovascular disease mortality (P trend = 0.036). The risk of coronary heart disease mortality was 51% lower in women who were 17 to 18 years old at menarche (95% CI, 0.25-0.95) than that in women who were younger than 17 years at menarche. An inverse relationship between age at first childbirth and the risk of cardiovascular disease mortality exists. In addition, early menarche may be a reproductive risk factor for coronary heart disease mortality.

Testosterone enhances estradiol's cardioprotection in ovariectomized rats

After menopause, the development of cardiovascular disease (CVD) is due not only to estrogen decline but also to androgen decline. This study examined the effects of either estradiol (E(2)) or testosterone replacement alone or E(2)-testosterone combination on isolated myocytes in ovariectomized (Ovx) rats subjected to ischemia/reperfusion (I/R). Furthermore, we determined whether the effects are associated with β(2)-adrenoceptor (β(2)-AR). Five groups of adult female Sprague-Dawley rats were used: Sham operation (Sham) rats, bilateral Ovx rats, Ovx rats with E(2) 40 μg/kg per day (Ovx+E), Ovx rats with testosterone 150 μg/kg per day (Ovx+T), and Ovx rats with E(2) 40 μg/kg per day+testosterone 150 μg/kg per day (Ovx+E/T). We determined the lactate dehydrogenase (LDH) release, percentage of rod-shaped cells and apoptosis of ventricular myocytes from rats of all groups subjected to I/R. Then, we determined the above indices and contractile function with or without a selective β(2)-AR antagonist ICI 118 551. We also determined the expression of β(2)-AR. Our data show that either E(2) or testosterone replacement alone or E(2) and testosterone in combination decreased the LDH release, increased the percentage of rod-shaped cells, reduced apoptotic cells (%), and combination treatment appeared to be more effective than either E(2) or testosterone replacement alone. ICI 118 551 abolished the effects of the three. Combination supplementation also enhanced the expression of β(2)-AR. We concluded that in Ovx rats, testosterone enhances E(2)'s cardioprotection, while E(2) and testosterone in combination was more effective and the protective effects may be associated with β(2)-AR. The study highlights the potential therapeutic application for CVD in postmenopausal women.

Chronic kidney disease in postmenopausal women

Menopause is derived from the Greek words men (month) and pauses (cessation) and means permanent cessation of menstruation after the loss of ovarian activity. Chronic kidney disease (CKD) has recently been associated with cardiovascular events in several studies. CKD patients have a heavy burden of traditional cardiovascular risk factors in addition to a range of nontraditional risk factors such as inflammation and abnormal metabolism of calcium and phosphate. In this review, the association of CKD and cardiovascular disease (CVD), as well as of osteoporosis in postmenopausal women is discussed. CKD mineral and bone disorder, characterized by disturbances of calcium/phosphate/parathyroid hormone, bone abnormalities and vascular and soft tissue calcification, is highly prevalent in CKD and is a strong, independent predictor of bone fracture, CVD and death. Estrogen has been shown to: (a) decrease the expression of angiotensin type 1 receptors in vasculature and kidneys; (b) reduce the expression and activity of angiotensin-converting enzyme, and (c) cause the release of angiotensinogen substrate from the liver. However, the degree of activation or suppression of the renin-angiotensin-aldosterone system by estrogen has not been clearly established. Clinical data on the effects of estrogen therapy on bone mineral densities are extremely limited in the ESRD population. CVD is the most common cause of death in postmenopausal women with CKD and many contributing factors have been explored. Future research for prevention of CVD in postmenopausal women with CKD would focus on the biology of vascular calcification as well as bone loss.

Lipid-soluble vitamin C palmitate and protection of human high-density lipoprotein from hypochlorite-mediated oxidation

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Endocannabinoid type 1 receptor gene (CNR1) polymorphisms (rs806381, rs10485170, rs6454674, rs2023239) and cardiovascular risk factors in postmenopausal women

Introduction. The risk of cardiovascular diseases (CVD) in women increases with menopausal stage. Obesity with metabolic disorders is the most important risk factor for CVD. The incidence of this phenotype of obesity increases in postmenopausal women. The endocannabinoid system plays an important role in regulation of several metabolic pathways. The aim of this work was to investigate whether genetic variations in the cannabinoid receptor gene (CNR1) can affect cardiovascular risk factors (e.g. fat distribution, obesity, fasting glucose, lipid profile, blood pressure, and free androgen and estrogen indexes) in postmenopausal women.Methods. The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms of the CNR1 gene were genotyped in 384 randomly selected postmenopausal Polish women (aged 50–60) using the minisequencing technique.Results. The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms were not significantly associated with anthropometric measures (waist circumference, carbohydrate and lipid metabolism, body mass index [BMI], total fat, glucose, insulin, fasting insulin resistance index [FIRI]). However, the rs2023239 polymorphism was associated with the free androgen index (p = 0.03).Discussion. It seems that further genotyping of the endocannabinoid receptor gene cannot be used as a significant marker of predisposition to CVD in postmenopausal women, but it would be interesting to study this interrelation on a larger population of postmenopausal women.

Neutrophil Count and Ambulatory Pulse Pressure as Predictors of Cardiovascular Adverse Events in Postmenopausal Women with Hypertension

Elevated neutrophil count, a marker of systemic inflammation, has been suggested as a prognostic marker of cardiovascular disease in postmenopausal women with hypertension. We tested the hypothesis that an association exists between elevated neutrophil count and increased arterial stiffness, as reflected by a wide pulse pressure (PP), in this population of women. We also tested PP as predictor of cardiovascular adverse events in this population. We analyzed data relating to 886 postmenopausal women with hypertension, consecutively enrolled in a prospective registry. Ambulatory blood pressure monitoring was carried out at entry in all the subjects. The median duration of follow-up was 7.4 years (range: 1-21 years). There was a direct relationship between neutrophil count and 24-h ambulatory PP (P < 0.0001) and this association remained significant after adjusting for age, serum glucose, and left ventricular (LV) hypertrophy at electrocardiogram (ECG) (all P < 0.01). During follow-up there were 121 first-time major cardiovascular (CV) events. The rate (× 100 patient-years) of CV events was 1.02, 1.36, and 3.75, respectively in the three tertiles of the distribution of 24-h PP (P < 0.0001). In a multivariate analysis, 24-h ambulatory PP and neutrophil count were independent predictors of total CV events after adjusting for the influence of other risk markers. In particular, for each 10 mm Hg increase in 24-h PP, there was a 73% higher risk for total CV events (P = 0.015). Office-recorded PP did not achieve significance when forced in the same model. Increased arterial stiffness, as reflected in high values of 24-h ambulatory PP, is an adverse prognostic marker in postmenopausal women with hypertension, possibly as an additional correlate of systemic inflammation.

Different effects of isoflavones on vascular function in premenopausal and postmenopausal smokers and nonsmokers: NYMPH study

Isoflavone intake has been associated with a reduction in the risk of cardiovascular disease in postmenopausal women. The aim of the present study was to determine if the effects of isoflavones on vascular function differ between premenopausal and postmenopausal women and between women who smoke and those who do not. Women smokers and nonsmokers who consumed 50mg of isoflavone/day as black soybean tea for a period of 2months (n=55, mean age 39) were enrolled in the present study. We examined endothelial function, which was assessed by the percent change in flow-mediated dilation (%FMD) and arterial wall stiffness using the cardio-ankle vascular index (CAVI), as well as by biochemical parameters of the blood. Neither premenopausal (p=0.697) nor postmenopausal (p=0.389) smokers experienced an increase in %FMD after daily consumption of isoflavones. However, both premenopausal (p=0.004) and postmenopausal (p=0.019) nonsmokers exhibited a marked elevation in %FMD. By contrast, isoflavone intake effectively reduced CAVI among both premenopausal smokers (p=0.027) and nonsmokers (p=0.013), but had no effect on CAVI among postmenopausal smokers (p=0.169) or nonsmokers (p=0.128). The women smokers and nonsmokers did not differ in age or %FMD at the time of enrollment in the study. Thus, isoflavones have different effects on vascular endothelial function and arterial wall stiffness in premenopausal and postmenopausal smokers and nonsmokers.

THE PROTECTIVE EFFECT OF QUERCETIN ON THE DEVELOPMENT OF METABOLIC SYNDROME IN THE OVARIECTOMIZED RATS FED WITH THE HIGH-FAT DIET

The aim of the study was to investigate the impact of quercetin on the metabolic manifestations of insulin resistance syndrome induced by high-fat diet in rats under estrogen deficiency. It was revealed that treatment with quercetin ameliorated insulin resistance, decreased visceral fat mass and lipid peroxidation in serum and heart, increased endogen nitric oxide production and decreased ADP-induced platelet aggregation in the ovariectomized rats fed with the high-fat diet. These results show that the quercetin may be used for treatment of the cardio-vascular diseases in postmenopausalwomen.

Ovariectomy in aged versus young rats augments matrix metalloproteinase-mediated vasoconstriction in mesenteric arteries

Ovarian deficiency is known to undermine vasoprotective mechanisms and accelerate cardiovascular disease in postmenopausal women. In a rat model of menopause (aged ovariectomized [Ovx] rats), we recently revealed a vasoconstrictor pathway mediated by matrix metalloproteinases (MMPs) via cleavage of big endothelin-1 (ET-1). However, the specific impact of aging and/or Ovx on this pathway remains unknown. We hypothesized that aging exacerbates MMP-mediated vasoconstriction in an ovary-deficient state. Young and aged female Sprague-Dawley rats, either intact or Ovx, were assessed for MMP-dependent vasoreactivity. Dose responses to big ET-1 in the absence or presence of an MMP inhibitor (GM6001) were tested on small mesenteric arteries using a pressure myograph system. MMP levels in the vascular tissue were measured by gelatin zymography. Both young Ovx and aged Ovx animals demonstrated a similar increase in the vasoconstriction to big ET-1 compared with the age-matched intact groups. MMP inhibition attenuated big ET-1 response in both Ovx groups and aged controls, but this effect was more pronounced in aged Ovx arteries (area under the curve reduction, 3.8 +/- 0.6 units in aged Ovx rats vs 1.5 +/- 0.5 units in young Ovx rats or 1.8 +/- 0.6 units in aged intact rats; P < 0.05). MMP-2 activity in the vascular tissue increased with age and was further augmented by Ovx. Regardless of age, ovarian loss increases vascular reactivity to big ET-1, which is mediated, in part, by MMP. Superimposed with advancing age, ovarian deficiency further increases the proconstrictor role of MMP, which corresponds with higher MMP-2 levels in the aging vessel wall. MMP-mediated vasoconstriction may be a mechanism contributing to vascular dysfunction in postmenopausal women.

O309 Breast arterial calcifications and cardiovascular disease in postmenopausal women

International Journal of Gynecology & ObstetricsVolume 107, Issue S2 p. S181-S181 Free communication (oral) presentations O309 Breast arterial calcifications and cardiovascular disease in postmenopausal women J. Ferreira, J. FerreiraSearch for more papers by this authorL. Pompei, L. PompeiSearch for more papers by this authorC. Fernandes, C. FernandesSearch for more papers by this authorL. Azevedo, L. AzevedoSearch for more papers by this authorE. Cunha, E. CunhaSearch for more papers by this authorR. Strufaldi, R. StrufaldiSearch for more papers by this authorI. Carelli, I. CarelliSearch for more papers by this authorS. Peixoto, S. PeixotoSearch for more papers by this author J. Ferreira, J. FerreiraSearch for more papers by this authorL. Pompei, L. PompeiSearch for more papers by this authorC. Fernandes, C. FernandesSearch for more papers by this authorL. Azevedo, L. AzevedoSearch for more papers by this authorE. Cunha, E. CunhaSearch for more papers by this authorR. Strufaldi, R. StrufaldiSearch for more papers by this authorI. Carelli, I. CarelliSearch for more papers by this authorS. Peixoto, S. PeixotoSearch for more papers by this author First published: 20 November 2009 https://doi.org/10.1016/S0020-7292(09)60681-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume107, IssueS2Abstracts of XIX FIGO World Congress of Gynecology and ObstetricsOctober 2009Pages S181-S181 RelatedInformation

DXA‐derived Abdominal Fat Mass, Waist Circumference, and Blood Lipids in Postmenopausal Women

The purpose of this study was to determine the utility of dual-energy X-ray absorptiometry (DXA)-derived fat mass indices for predicting blood lipid profile in postmenopausal women. A secondary purpose was to determine whether waist circumference is comparable with DXA-derived measurements in predicting blood lipid profile. Subjects were 423 postmenopausal women (age 58.1 +/- 6.3 years). Fat mass was assessed at abdomen, trunk, and total body using DXA. Anthropometric measurements included BMI and waist circumference. Blood samples were analyzed for total cholesterol (TC), triglyceride (TAG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and cholesterol/HDL ratio. Of the DXA-derived measures, abdominal-fat mass was the best predictor of blood lipid profiles. DXA-derived abdominal fat mass and waist girth explained 20 and 16.5% of variation in TC/HDL ratio, respectively, in univariate analysis, with no difference between the slopes of the regression coefficients. Eighty-four percent of subjects were common to the top quartiles of waist circumference and abdominal fat mass, and blood lipid profiles generally worsened across increasing quartiles. DXA-derived abdominal fat mass and waist circumference are of equivalent utility for predicting alterations in blood lipids. Waist circumference is, therefore, ideal as an inexpensive means in primary health-care services for predicting risk of cardiovascular diseases in postmenopausal women.

Local Effects of Vaginally Administered Estrogen Therapy: A Review.

The results of the Women's Health Initiative (WHI) led to a distinct decline in the routine use of estrogen as preventive therapy for vasomotor symptoms, osteoporosis, and cardiovascular disease in postmenopausal women. Without estrogen replacement, one third of women experience symptoms of atrophic vaginitis including dryness, irritation, itching and or dyspareunia. Local application of estrogen has been shown to relieve these symptoms and improve quality of life for these women. In addition, local estrogen therapy may have a favorable effect on sexuality, urinary tract infections, vaginal surgery, and incontinence. This review examines the effects of vaginally applied estrogen on the vaginal epithelium, urethra and endometrium. An accompanying review examines the systemic effects of vaginally applied estrogen.

High‐oleic ground beef, exercise, and risk factors for cardiovascular disease in postmenopausal women

High‐oleic ground beef, in addition to exercise, was hypothesized to reduce cardiovascular risk factors in post‐menopausal women. Eight post‐menopausal women participated in a crossover design consisting of two 6‐week treatment periods with a 4‐week washout period in between. Both treatments were ground beef patties differing only in fatty acid composition (monounsaturated fat: saturated fat was 0.85 (patty 1) and 1.4 (patty 2)). During the exercise bout 500 kcal were burned at 70% of the subject's VO2 max. Plasma and serum samples were taken at baseline, 24 hours pre‐exercise, and 24 hours post‐exercise. Patty 2 caused a significant reduction in total cholesterol before exercise (p = 0.1). This was due in most part, to a reduction in LDL cholesterol, as no significant reduction in HDL cholesterol was seen. After exercise, there was a significant increase in total cholesterol (p = 0.1) back to baseline values in those subjects who consumed patty 2. Glucose and triglycerides were not significantly affected by the diet exercise interaction. The data indicate that high‐oleic ground beef can reduce some cardiovascular risk factors and can be a part of a healthful diet.

Association of Polymorphism of Estrogen Receptor-.ALPHA. Gene with Circulating Levels of Adiponectin in Postmenopausal Women with Type 2 Diabetes

Menopause is a risk factor for cardiovascular disease (CVD) in women because of the reduction in endogenous estrogen. Recently, single nucleotide polymorphisms (SNPs) of the estrogen receptor alpha (ESR-1) gene (c.454-397T>C) associated with the prognosis of myocardial infarction in postmenopausal women were identified; however, the mechanism by which genetic variation of ESR-1 contributes to the pathogenesis of CVD is unknown. Circulating levels of adipokines and inflammatory cytokines predict CVD risk; hence, this study aimed to investigate whether ESR-1 genotypes (c.454-397T>C) might influence circulating levels of adipokines and inflammatory cytokines in postmenopausal women with type 2 diabetes. Sixty-three postmenopausal women with type 2 diabetes were recruited. Serum levels of adiponectin, resistin, interleukin-6 (IL-6), and high-sensitive C-reactive protein (hs-CRP) were determined. The genotype of ESR-1 was closely associated with serum adiponectin, which was decreased in subjects with the T allele and was lowest in those with the T/T genotype. Multiple logistic regression analysis revealed independent contribution of the homozygote for the T allele to low serum levels of adiponectin. The T allele of the c.454-397T>C SNP of ESR-1 is associated with low serum levels of adiponectin, which may lead to a high risk of CVD in postmenopausal women.