Compliance In Postmenopausal Women Research Articles

Equol Producing Status Affects Aerobic Exercise Training-induced Increase In Arterial Compliance In Postmenopausal Women

Equol Producing Status Affects Aerobic Exercise Training-induced Increase In Arterial Compliance In Postmenopausal Women

Equol-producing status affects exercise training-induced improvement in arterial compliance in postmenopausal women.

Central arterial compliance decreases drastically after menopause. Regular intake of soy isoflavone and aerobic exercise increase arterial compliance. The equol is a metabolite of isoflavone daidzein by gut microbiome. We determined whether the equol-producing status affects aerobic exercise-induced improvement in carotid arterial compliance. Forty-three postmenopausal women were assigned to two intervention groups: 1) exercise and isoflavone (Ex+Iso, n = 27 females) or 2) isoflavone interventions (Iso; n = 16 females). Participants of the Ex+Iso intervention group completed an 8-wk aerobic exercise training, and all participants were administered with oral isoflavone supplements during the interventions. The equol-producing status (equol producers or nonproducers) was determined from urine equol concentrations after a soy challenge. In the Ex+Iso intervention group, carotid arterial compliance increased in the equol producers (0.084 ± 0.030→0.117 ± 0.035 mm2/mmHg), but not in the nonproducers (0.089 ± 0.028→0.097 ± 0.026 mm2/mmHg) after the intervention (interaction effect; P < 0.05). The magnitude of increases in carotid arterial compliance was significantly greater in the equol producers than in the non-equol producers (P < 0.05). In the isoflavone intervention group, there were no changes in any parameters after the intervention irrespective of the equol status. These results suggest that equol-producing status is obligatory to aerobic exercise training-induced improvements in central arterial compliance in postmenopausal women.NEW & NOTEWORTHY Isoflavone intake and aerobic exercise increase central artery compliance. Equol, a metabolite of isoflavone daidzein by gut microbiome, has beneficial effects on vascular function. We demonstrated for the first time that the interaction of aerobic exercise and equol production status plays an essential role in improvements in central artery compliance in postmenopausal women. More specifically, the equol-producing status was obligatory to exercise training-induced improvements in central arterial compliance in postmenopausal women.

Self-directed Learning and Its Impact on Menopausal Symptoms.

Background:One of the main criteria to verify the effectiveness of a health training program is to measure quality of life in menopausal women.Objectives:Hence the aim of this review was to evaluate the effects of self-directed learning (SDL) on MENQOl.Patients and Methods:The present single blind field study was conducted in Saadatmandi Health Center of Robat Karim (Iran, Southwest of Tehran Province) from August to December 2010. One handred and ten menopausal women were selected using convenience sampling method and then divided into two experimental (Self-directed Learning) and control groups of 55 each. Four manuals were developed to guide the women in the experimental group containing practical ways to treat menopausal symptoms. They were distributed among the participants for four weeks on a specific day. Menopausal Specific Quality of Life Questionnaire (MENQOL) was used to determine and compare quality of life scores of these women (before and three months after intervention sessions). The control group did not receive any intervention. Statistical analysis was performed by SPSS/16 software using Kolmogorov-Sminov, ANOVA, independent paired t test and Chi-square test.Results:There were significant statistical differences between two groups regarding the age of subjects; age of menopause; economic, educational and employment status; number of dead and living children; BMI and vasomotor, physical, sexual and psycho-social postmenopausal symptoms. The implementation of Self-directed Learning (SDL) model leads to a significant statistical difference in scores of vasomotor symptoms (16.32 ± 5.92 to 13.26 ± 5.31), psychosocial symptoms (34.8 ± 11 to 27.18 ± 10.83), physical symptoms (75.02 ± 18.07 to 61.42 ± 15.49), sexual symptoms (15.36 ± 6.10 to 12.00 ± 4.97) and the overall score for quality of life (141.5 ± 41.09 to 113.86 ± 36.6) (P < 0.001). No significant changes were found in the QOL scores of the control group.Conclusions:Implementation of self-directed learning provides a useful strategy that should be included in health intervention and national surveillance programs in order to improve health and therapeutic compliance in postmenopausal women.

장기간 골다공증관리교육이 골밀도와 약물순응도에 미치는 효과

Purpose: The purpose of this study was to evaluate the effects of long term osteoporosis management education consist of exercise, drug therapy, and nutrition on bone mineral density (BMD) and medication compliance among postmenopausal women who have just been diagnosed with osteoporosis. Methods: The research design consisted of a pre-and post-test quasi-experimental design through a nonequivalent control group. The participants in this study were 60 individuals with osteoporosis, and who were classified according to two groups; the control group (n=30) who were given general clinical guidelines, and the experimental group (n=30) who received management education once for 60 minutes every three months using a standardized educational sheet. After one year, BMD was assessed using band dual energy X-ray absorptiometry (DXA) and medication possession ratio (MPR) for medication compliance. Analysis of collected data was performed using descriptive statistics t-test, chi-test, and paired t-test. Results: No significant difference in BMD (t=-1.02, p=.311) and MPR (t=-0.77, p=.440) was observed between the two groups. However, a significant increase in femur neck BMD was observed in the experimental group compared with the control group (t=-2.18, p=.033). Conclusion: Conduct of further study will be needed for examination of the effect of long-term osteoporosis management education on BMD Level and Medication Compliance in Postmenopausal Women.

Aerobic Exercise Training Decreases Plasma Asymmetric Dimethylarginine Concentrations With Increase in Arterial Compliance in Postmenopausal Women

Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, increase with advancing age and menopausal status. ADMA plays a role in endothelial dysfunction and increasing arterial stiffness. Regular aerobic exercise has a positive effect on arterial function (i.e., arterial compliance). This study investigated the effects of aerobic exercise training on plasma ADMA concentrations and arterial compliance in postmenopausal women. Thirty postmenopausal women were divided into 2 groups: an exercise group (n = 20) and a control group (n = 10). Subjects in the exercise group completed 12 weeks of aerobic exercise training (65%-80% of maximal heart rate, 40-60 min/day, 3-6 days/week). Before and after each intervention, plasma ADMA concentrations and carotid arterial compliance were measured in all participants. The baseline plasma ADMA concentrations, carotid arterial compliance, and most other key dependent variables did not differ between the 2 groups. In the exercise group, carotid arterial compliance significantly increased after exercise intervention (P < 0.01), and plasma ADMA concentrations significantly decreased (P < 0.05). In addition, changes in carotid arterial compliance after the exercise intervention were inversely correlated with changes in plasma ADMA concentrations (r = -0.367; P < 0.05). We demonstrated that aerobic exercise training significantly decreased plasma ADMA concentrations with increase in carotid arterial compliance in postmenopausal women. These results suggest that reduction in ADMA may play an important role in the aerobic exercise training-induced increase in arterial compliance.

Effects of curcumin intake and aerobic exercise training on arterial compliance in postmenopausal women

BackgroundReduction in arterial compliance with aging increases the risk of cardiovascular disease. Lifestyle modification, particularly aerobic exercise and dietary modification, has a favorable effect on vascular aging. Curcumin, a major component of turmeric, is an anti-inflammatory agent. Therefore, it is plausible to hypothesize that curcumin improves arterial compliance. We investigated the effects of curcumin ingestion alone and in combination with aerobic exercise training on arterial compliance in postmenopausal women. MethodsA total of 51 postmenopausal women were assigned to 4 groups: placebo, curcumin, exercise and placebo (Ex + placebo), and exercise and curcumin (Ex + curcumin). Curcumin or placebo was ingested orally for 8 weeks. The exercise groups underwent moderate aerobic exercise training for 8 weeks. ResultsCarotid arterial compliance increased significantly in the curcumin, Ex + placebo, and Ex + curcumin groups, whereas no such changes were observed in the placebo control group. The magnitude of increases in carotid arterial compliance was the greatest in the Ex + curcumin group. ConclusionWe concluded that curcumin ingestion improves carotid arterial compliance and that the combination of curcumin and aerobic exercise training was more efficacious in increasing central arterial compliance than either of these treatments alone in postmenopausal women.

P5-17-05: 24 Months Follow-Up Results from PACT (Patient's Anastrozole Compliance to Therapy Programme), a Non-Interventional Study Evaluating the Influence of a Standardized Information Service on Compliance in Postmenopausal Women with Early Breast Cancer.

Abstract Introduction: According to recent retrospective studies, compliance to adjuvant endocrine therapy for early breast cancer (EBC) may drop to below 70% after one year and to as low as 50% by year 4. PACT aimed to increase treatment adherence in postmenopausal women taking an adjuvant aromatase inhibitor via a standardized information service (educational arm). Yet, after 12 months, there was no difference in compliance between the standard and educational arm (reported at this meeting 2010). Methods: PACT is a prospective, randomised, two-arm parallel-group study in Germany, sponsored by AstraZeneca (NCT00555867). Postmenopausal women on anastrozole for hormone-receptor positive (HR+) EBC were randomized to routine clinical care alone or to receive additional standardized information (educational arm) at nine times over the first 12 months of adjuvant therapy. Primary endpoints were compliance and persistence rates in the educational versus routine arm after 12 months. Secondary endpoints included longer follow-up, reasons for non-compliance, influence of baseline characteristics, and clinical outcome parameters (DSF, OS). Compliance was evaluated via patient questionnaires, prescription data and physician recall. Per protocol compliance was analysed only for patients with full documentation both by patients and physicians. Persistence was defined as the duration of time from initiation to discontinuation of therapy (Cramer et al 2007) and measured by prescription data. Results: PACT enrolled 4,923 female patients at 109 breast centres and 1,361 registered specialist practices from all regions in Germany. 4,397 patients were evaluable for baseline characteristics. 2,707 patients were evaluable for the primary endpoint (full documentation on tablet intake both by patients and physicians). No difference in compliance could be shown between the standard (88.2%) and the educational arm (88.3%) at 12 months (p=0.92, Fisher's exact test). Persistence rates were 40.3% for the standard arm and 43.0% for the educational arm, respectively (p=0.17, Fisher's exact test). At 24 months, data from 1539 patients was available for analysis compliance per protocol. Compliance rates were 88.7% (educational arm) and 87% (standard arm; p=0.29). Persistence again much lower at 41.1% and 42.1% (p=0.68). Variables influencing compliance were regular attendance to follow-up visits, participation in a cancer rehabilitation program, number of co-morbidities and current employment status. Persistence was influenced by factors such as tumour stage, joint pain and cancer rehab program participation. Conclusion: The addition of standardized information materials to standard clinical care did not lead to a significant increase in compliance or persistence rates at 12 or 24 months. With 4,923 women included, the PACT study represents the largest prospective study to evaluate the influence of educational material as well as baseline demographic and histopathological characteristics on the compliance and persistence to adjuvant endocrine therapy in postmenopausal patients with HR+ EBC. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-17-05.

24-month follow-up from the Patient’s Anastrozole Compliance to Therapy (PACT) program evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer.

24-month follow-up from the Patient’s Anastrozole Compliance to Therapy (PACT) program evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer.

First results from the Patient's Anastrozole Compliance to Therapy (PACT) program evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer (EBC).

523 Background: Retrospective data show that compliance to adjuvant endocrine therapy for early breast cancer (EBC) may drop below 80% after 1 year and as low as 50% by year 4. PACT aims to increase treatment adherence in postmenopausal women taking adjuvant anastrozole via a standardized information service. Methods: PACT is a prospective, randomised, two-arm parallel group trial with 60 months follow-up. Women on anastrozole for hormone receptor-positive (HR+) EBC were randomized to routine clinical care alone or additional standardized information for the first 12 months of adjuvant therapy. Primary endpoint is the compliance rate after 12 months. Secondary endpoints include reasons for noncompliance, influence of baseline characteristics, and clinical outcome parameters. Compliance is evaluated via patient questionnaires, prescription data and physician recall. Results: 4,924 women were enrolled by November 2008, the average age was 64.7 years. 97.7% were ER+, 8.4% HER2+, mean tumour size 21.4 mm, 74.5% had received breast preserving surgery, 23.5% a mastectomy, 6.7% had had neoadjuvant chemotherapy and almost 40% received adjuvant chemotherapy. 85% were scheduled for adjuvant radiotherapy. Analysis of the primary endpoint compliance at 12 months will be performed after data base lock in February 2010. Conclusions: PACT is the largest prospective trial to date on compliance in HR+ EBC and aims to clarify whether standardized information services throughout year one may improve compliance to adjuvant endocrine treatment and influence outcomes in postmenopausal women with HR+ EBC. Sponsored by AstraZeneca. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca AstraZeneca, Roche AstraZeneca

Factors affecting the compliance of post-menopausal women over the course of a 24 week progressive resistance training programme

Factors affecting the compliance of post-menopausal women over the course of a 24 week progressive resistance training programme

First Results from the “Patient's Anastrozole Compliance to Therapy Programme” (PACT) Evaluating the Impact of a Standardized Information Service on Compliance in Postmenopausal Women with Early Breast Cancer (EBC) Receiving Adjuvant Endocrine Therapy.

Abstract Background: In adjuvant treatment of hormone-responsive breast cancer, existing data document that 23% and 50% of patients were non-compliant after the first and fourth year of tamoxifen (TAM) therapy, respectively. Here, we present the PACT-study that aims to increase awareness, motivation and adherence to oral hormonal therapy, namely the aromatase inhibitor anastrozole, in routine clinical practice by simple interventions such as written standardized mailings and reminder services.Materials and Methods: In this two arm, parallel group trial with a primary duration of 12 months and 60 months follow-up, women with hormone receptor positive EBC receiving anastrozole once daily were randomized to either routine clinical care alone or to receiving additional standardized information for the first 12 months of adjuvant therapy. Primary endpoint is compliance rate in the standard versus intervention arm after 12 months, where compliance is defined by an 80% intake of the total medication. Secondary endpoints include persistence on therapy, reasons for non-compliance, influence of baseline characteristics, and of compliance on clinical outcome parameters.Compliance was evaluated by self report using standardized, detailed questionnaires at baseline and after each year of treatment. In addition, the prescription data for each patient from hospital records and physician recall was collected. Finally, quality of life and patient satisfaction were assessed using standardized questionnaires.Results: From July 2006 until November 2008, 4.924 women were enrolled with a median patient age of 64 years. Besides demographic data and patient characteristics results of patient's self reporting data will be shown for the first time at this meeting.Conclusion: PACT is the largest prospective investigation on compliance regarding an aromatase inhibitor as adjuvant therapy so far. The programme's goals are to clarify what aspects influence patients' adherence to prescribed medication and how motivation for regular intake can be accomplished. Furthermore, PACT seeks to prove if a simple intervention such as a standardized information and reminder services throughout the first year of treatment may improve compliance and thus eventually influence treatment outcomes. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6079.

Additive beneficial effects of lactotripeptides and aerobic exercise on arterial compliance in postmenopausal women

Central arterial compliance plays an important role in the functional abilities of the vasculature. Two active tripeptides, valine-proline-proline and isoleucine-proline-proline, were isolated from sour milk and were referred to as lactotripeptides (LTP). Because LTP appears to act as an angiotensin-converting enzyme inhibitor, it is plausible to hypothesize that LTP improves arterial compliance. We determined the effects of LTP ingestion alone or in combination with regular aerobic exercise on arterial compliance. A total of 55 postmenopausal women (50-65 yr old) were randomly divided into four groups: placebo, LTP, exercise and placebo (Ex + placebo), or exercise and LTP (Ex + LTP). LTP or placebo was administered orally for 8 wk. The exercise groups completed an 8-wk moderate aerobic exercise intervention. There were no differences in baseline arterial compliance and most other key dependent variables among the groups. Carotid arterial compliance increased significantly in the LTP (0.93 + or - 0.07 vs. 0.99 + or - 0.08 mm(2)/mmHg x 10(-1)), Ex + placebo (0.92 + or - 0.04 vs. 1.00 + or - 0.05 mm(2)/mmHg x 10(-1)), and Ex + LTP groups (0.86 + or - 0.06 vs. 1.00 + or - 0.06 mm(2)/mmHg x 10(-1)), whereas no such changes were observed in the placebo control group (0.86 + or - 0.06 vs. 0.85 + or - 0.07 mm(2)/mmHg x 10(-1)). The magnitude of increases in carotid arterial compliance was significantly greater in the Ex + LTP group (19 + or - 4%) than in other groups. The improvements in arterial compliance with LTP were associated with the corresponding reductions in arterial blood pressure and plasma angiotensin II concentrations. We concluded that LTP ingestion improves carotid arterial compliance and that the combination of LTP ingestion and regular exercise is additive and synergistic in improving arterial compliance in postmenopausal women.

5035 The patient's anastrozole compliance to therapy programme (PACT): evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer

Cytotoxic chemotherapy suppresses the hematopoietic system, impairing host protective mechanisms. One important consequence, chemotherapy-induced neutropenia (CIN), places patients at risk of developing fever and life-threatening infections. These complications have substantial economic impact and may severely affect the quality of life of patients undergoing treatment of cancer. Currently, CIN is managed by delaying and reducing chemotherapy treatment with hematopoietic growth factors and with intravenous antibiotic therapy. Reducing chemotherapy may compromise treatment outcomes in potentially curable malignancies, such as early stage breast cancer and non-Hodgkin’s lymphoma. Randomized clinical trials have clearly shown that granulocyte colony-stimulating factor (filgrastim) and the longer-acting pegylated granulocyte colony-stimulating factor pegfilgrastim, when administered 24 hours after chemotherapy before the occurrence of CIN, are effective in reducing the incidence and severity of neutropenia and its complications, including administration of full doses of chemotherapy without treatment delay. Dose-dense chemotherapy, ie, the administration of standard-dose chemotherapy in shorter cycles (made feasible with growth factor support), has recently been shown to improve outcomes in early stage breast cancer and non-Hodgkin’s lymphoma. This review summarizes the clinical consequences of CIN and describes current best practices for the management of patients at risk for CIN.

First data from the the Patient's Anastrozole Compliance to Therapy Programme evaluating the influence of a standardized information service on compliance in postmenopausal women with early breast cancer

e11592 Background: Retrospective pharmacy data suggest that within the first year of therapy patients’ pick-up rate of aromatase inhibitor (AI) packs prescribed for early breast cancer (EBC) drops below 70%. Little is known about compliance to AI and patient motivation outside of clinical trials and the effect of compliance on patient outcome. Methods: The Patient´s Anastrozole Compliance to Therapy (PACT) programme, a two arm, randomized parallel group trial with 60 months follow-up, randomized postmenopausal women with HR+ EBC receiving anastrozole as adjuvant treatment and who consented to participate, to routine clinical care alone or additional standardized information consisting of 9 mailings of brochures and letters over the first 12 months following initiation of therapy. Primary endpoint is compliance rate in the standard versus intervention arm after 12 months, secondary endpoints include safety, reasons for non-compliance, influence of baseline characteristics, and of compliance on clinical outcome parameters. Compliance was evaluated by patient self reporting via standardized questionnaires, cross-checks of prescription data from hospital records and physician recall. QoL and patients’ satisfaction are assessed with standard questionnaires. Results: From Jul 2006 to Nov 2008, 4,924 patients were enrolled. Demographic data and baseline characteristics including median age, disease parameters, BMI, QoL at study start, co-morbidities and concomitant medication will be presented Conclusions: As of today, PACT is the largest prospective investigation on compliance to AI. It will provide valuable insights into the reasons for non-compliance to adjuvant AI therapy and demonstrate if a simple intervention such as standardized written information throughout the first treatment year may improve compliance and patient outcome. [Table: see text]

0244 A quality initiative: Guideline compliance in postmenopausal women with stage IB-IIIC early breast cancer receiving adjuvant hormonal therapy

0244 A quality initiative: Guideline compliance in postmenopausal women with stage IB-IIIC early breast cancer receiving adjuvant hormonal therapy

Ascorbic Acid Selectively Improves Large Elastic Artery Compliance in Postmenopausal Women

The compliance of large elastic arteries in the cardiothoracic region decreases with advancing age/menopause and plays an important role in the increased prevalence of cardiovascular diseases in postmenopausal women. We determined whether oxidative stress contributes to the reduced large elastic artery compliance of postmenopausal women. Carotid artery compliance was measured during acute intravenous infusions of saline (baseline control) and supraphysiological doses of the potent antioxidant ascorbic acid in premenopausal (n=10; 23+/-1; mean+/-SE) and estrogen-deficient postmenopausal (n=21; 55+/-1 years) healthy sedentary women. Carotid artery compliance was 56% lower in postmenopausal compared with premenopausal women during baseline control (P<0.0001). Ascorbic acid infusion increased carotid artery compliance by 26% in postmenopausal women (1.11+/-0.07 to 1.38+/-0.08 mm2/mm Hgx10(-1); P<0.001) but had no effect in premenopausal women (2.50+/-0.25 versus 2.43+/-0.20 mm2/mm Hgx10(-1)). Carotid artery diameter, blood pressure, and heart rate were unaffected by ascorbic acid. In the pooled population, the change in arterial compliance with ascorbic acid correlated with baseline waist-to-hip ratio (r=0.56; P=0.001), plasma norepinephrine (r=0.58; P=0.001), and LDL cholesterol (r=0.54; P=0.001). These results suggest that oxidative stress may be an important mechanism contributing to the reduced large elastic artery compliance of sedentary, estrogen-deficient postmenopausal women. Increased abdominal fat storage, sympathetic nervous system activity, and LDL cholesterol may be mechanistically involved in oxidative stress-associated suppression of arterial compliance in postmenopausal women.

The effect of hormone replacement therapy on vascular compliance in postmenopausal women

P-266 Key Words: Postmenopausal, Pulse Wave Velocity, Ambulatory Blood Pressure Monitoring

Effect of Low-Intensity Aerobic Exercise Training on Arterial Compliance in Postmenopausal Women

Regular aerobic exercise training attenuates age-related reduction in central arterial compliance, an independent risk factor of cardiovascular diseases. We tested the hypothesis that even low-intensity exercise training could increase central arterial compliance in postmenopausal women. Using B-mode ultrasound, we studied the central arterial compliance of 15 postmenopausal females (age: 52-66 years) before and after a 12-week aerobic exercise intervention. Subjects performed aerobic exercise training of the same energy expenditure (cycle exercise, total 900 kcal/week, 3-5 sessions/week) at two different exercise intensities: 7 trained at low intensity (40% heart rate reserve: L-TR) and 8 trained at moderate intensity (70% heart rate reserve: M-TR). Arterial compliance increased after exercise training in the L-TR group (0.70+/-0.32 vs. 1.06+/-0.55 mm2/mmHgX10(-1), p <0.05) and in the M-TR group (0.82+/-0.37 vs. 1.14+/-0.39 mm2/mmHgX10(-1), p <0.05). There was no significant difference in increases of arterial compliance in either group (L-TR: 0.35+/-0.38 vs. M-TR: 0.32+/-0.33 mm2/mmHgX10(-1)). These results suggest that the improvement of central arterial compliance by aerobic exercise training might not be influenced by the intensity of exercise training if the energy expenditure of the training is the same. Accordingly, even low-intensity exercise training may have the effect of improving central arterial compliance.

A randomised, double-blind trial comparing raloxifene HCl and continuous combined hormone replacement therapy in postmenopausal women: effects on compliance and quality of life

Objective To compare continuous combined hormone replacement therapy (ccHRT) and raloxifene with respect to compliance and quality of life, which were predefined secondary endpoints of a large, prospective study designed to investigate the uterine effects of both treatments. Design Double-blind, randomised controlled trial of six-month duration. Setting One hundred and twenty-nine gynaecology hospital departments, clinics or practices specialised in women's healthcare, located in Europe, South Africa and Israel. Population Healthy postmenopausal women ( n = 1008). Main outcome measures Changes in quality of life using the Women's Health Questionnaire (WHQ) and compliance using a compliance questionnaire and pill count. Adverse event and early discontinuation rates and satisfaction with treatment using a visual analogue scale (VAS). Results Women taking raloxifene reported greater satisfaction with their treatment as assessed on the VAS ( P = 0.004),and a lower proportion, as compared with ccHRT, reported being worried by the treatment (9.6% vs 20.2%, P < 0.01). Women taking ccHRT reported greater deterioration in scores from the WHQ for depressed mood and menstrual symptoms than those taking raloxifene ( P < 0.01). For memory, vasomotor symptoms and sexual behaviour, the ccHRT group reported significantly greater mean improvements ( P < 0.05). Over half (58.8%) of those taking raloxifene noticed no effect, 37.7% felt better and 3.4% felt worse as measured using the compliance questionnaire. Fifty percent of the women taking ccHRT felt better, 37.8% noticed no effect but over 10% felt worse. More women on raloxifene (94.6%) than on ccHRT (85.9%) reported that they were taking their double-blinded medication regularly ( P < 0.01). Conclusions A lower rate of adverse event-related discontinuations, the lack of negative effects on quality of life and a smaller proportion of women being worried by the drug treatment were associated with higher treatment satisfaction and better compliance in postmenopausal women taking ccHRT or raloxifene.

The effect of hormone replacement therapy on arterial blood pressure and vascular compliance in postmenopausal women with arterial hypertension

Arterial pathology is a major contributor to cardiovascular disease, morbidity and mortality. Women are at higher risk of cardiovascular disease after menopause. Arterial stiffness determined by pulse wave velocity, increases with age both in men and women, whereas arterial compliance in premenopausal women is greater than in men of similar age. This difference is lost in the postmenopausal years, with evidence of rapid decline in arterial compliance in the perimenopausal period. Loss of hormonal modulation is a likely explanation for reduced arterial compliance in postmenopausal women. Long-term treatment with hormone replacement therapy (HRT) may be expected to partially reverse the increase in arterial stiffness. The aim of the study was to analyse the effect of HRT on blood pressure and arterial compliance in postmenopausal women with arterial hypertension receiving hypotensive drugs. The results in the present study of postmenopausal women with mild to moderate arterial hypertension receiving HRT showed only a transient tendency towards lower blood pressure. In our study HRT was found to improve arterial compliance at 3 months after HRT, and the effect was maintained throughout 12 months. The increased arterial compliance in women receiving HRT was independent of blood pressure. In parallel with decreasing pulse wave velocity women receiving HRT had lower total and low-density lipoprotein cholesterol. The conclusions were that after 1 year HRT in postmenopausal women with arterial hypertension improves circadian blood pressure pattern, but it does not affect significantly blood pressure values and variability. The present study also shows that HRT significantly inhibits age-related rigidity of large arteries.