Hormone Replacement Therapy Status Research Articles

STROKE VOLUME DECLINES DURING EXERCISE IN POSTMENOPAUSAL WOMEN.

1960 We examined the effects of different levels of physical activity (PA) and hormone replacement therapy (HRT) on exercise stroke volume (SV) during submaximal and maximal treadmill exercise in postmenopausal women (63±5 yr). Eleven sedentary women (SED), 19 PA women, and 14 athletic women (ATH) were studied; 20 women were on HRT and 24 women were not on HRT. Data were collected for VO2, heart rate (HR), cardiac output (acetylene rebreathing), and blood pressure (BP) during exercise at 40, 60, 80, and 100% of VO2max. SV was calculated from cardiac output and HR. HRT status did not have a significant effect on SV within physical activity groups. (Table)TableThe ATH had a significantly greater SV (p≤0.05) than either the PA or SED groups at all intensities of exercise. Repeated measures ANOVA indicated that PA or HRT status did not affect the pattern of change in SV as exercise intensity increased. There were no differences in SV between 40 and 60% VO2max but SV decreased significantly between 60 and 100% VO2max in each group and the decrease in SV was not different between groups. These data demonstrate that SV declines during exercise in postmenopausal women and that the decline appears to be similar in women with markedly different habitual physical activity levels. Supported by Pennsylvania Affiliate of the American Heart Association and AARP Andrus Foundation.

Effects of hormone replacement therapy on QT interval

We evaluated the electrocardiograms of 208 postmenopausal women (ages 40 to > or = 70 years) without heart disease, medications that could alter the QT interval, use of vaginal estrogens, unknown hormone replacement therapy, or electrocardiographic abnormalities both with (n = 76) and without (n = 132) hormone replacement therapy, and found no significant effects of hormone replacement therapy status on heart rate, QT interval, or the corrected QT interval. Thus, estrogen and/or progesterone effect does not explain the gender differences in myocardial repolarization.

Hormonal, Metabolic, and Cellular Influences on Cardiovascular Disease in Women

A recent survey commissioned by the American Heart Association found that only 7% of all women identify heart disease as their greatest health threat, despite the fact that it is actually the leading cause of death in women. With increasing awareness in the medical as well as the lay community of the major role cardiovascular disease plays in morbidity and mortality of women, there has been mounting attention to gender differences in cardiovascular disease. It is striking that heart disease does not begin to appear in noticeable numbers in women until after menopause, a fact that stimulates discussion and investigation of the role of estrogen in warding off the ravages of atherosclerosis. This book is a comprehensive and scholarly discussion of the current state of knowledge of possible mechanisms for interaction between estrogen and cardiovascular disease in women. Although it has been known for some time that estrogen regulates lipoprotein binding and clearance by the liver with a favorable effect on the lipid …

Social Physique Anxiety in Postmenopausal Women

ABSTRACT Social physique anxiety (SPA), (he degree to which individuals become anxious when others observe their bodies, is an important concept for postmenopausal women because it may be directly related to their physical activity behavior. Women with high levels of social physique anxiety may not participate in health-enhancing physical activity. Therefore, the main purpose of this study was to examine SPA in postmenopausal women relative to leisure lime physical activity (LTPA, activities such as exercise, recreation, and sports). Other factors, such as percent body fat, body fat distribution, age, and hormone replacement therapy status were also examined for their relationship to SPA. Women who expended ≤ 2,000 kcal-wk−1 in LTPA had significantly higher SPA than women who expended ≥ 500 kcal. Wk−1 independent of percent body fat. Women with more than 37.5% body fat had significantly higher SPA than those with less than 37.5% body fat. Women with upper BFD (waist-to-hip ratio or WHR > 0.85) had higher SPA than women with lower BFD (WHR < 0.75). There were no differences in SPA relative to age or HRT status. It appears that a sedentary lifestyle, high percent body fat, and upper body fat distribution are associated with increased SPA in postmenopausal women, thus health promotion professionals should be aware of these concerns when developing physical activity interventions for postmenopausal women.

Hormone replacement and menopausal symptoms following hysterectomy.

Hormone replacement therapy (HRT) is recommended for most women who experience surgical menopause following hysterectomy/oophorectomy for noncancerous conditions; it is also commonly prescribed for postmenopausal women. Beginning in 1992, 1,299 women undergoing hysterectomy in 28 hospitals throughout Maryland were interviewed prior to hysterectomy and were subsequently followed over a 2-year period. Interviews included questions about HRT use and symptoms associated with menopause. The majority of the women (66 percent) were white, 55 percent had a high school education or better, 49 percent were obese (body mass index > or =27.3), and 11 percent were postmenopausal. Over 40 percent of premenopausal women underwent bilateral oophorectomy. At 3 months posthysterectomy, 89 percent of these women were on HRT; this figure dropped to 85 percent at 24 months. Among postmenopausal women, 50 percent were on HRT both at 3 months and at 24 months posthysterectomy. Among premenopausal women who had unilateral oophorectomy, 21 percent were on HRT at 3 months, increasing to 35 percent at 24 months. Among premenopausal women who had no ovaries removed, 5 percent were on HRT at 3 months, increasing to 13 percent at 24 months. There were few within-group differences between HRT users and nonusers, except that among postmenopausal women, HRT users were younger and more likely to be white and had higher income and educational levels. Women who were postmenopausal or who underwent bilateral oophorectomy were less likely to have hot flashes if they were on HRT, but women with 0-1 ovary removed who were on HRT were more likely to have hot flashes than those not on HRT. Black women were significantly more likely to experience hot flashes than were white women, independent of HRT status and weight. Obese women were on HRT at approximately the same rates as nonobese women but were significantly more likely to have hot flashes, even when analyses controlled for HRT and race.

Plasma fibrinogen levels in healthy postmenopausal women: physical activity and hormone replacement status.

Fibrinogen is a major component of the coagulation system and a powerful independent risk factor for cardiovascular disease in postmenopausal women. Regular physical activity has been recommended as an effective clinical approach to lowering plasma fibrinogen levels; currently, however, there are little or no data to support a relationship between habitual exercise status and plasma fibrinogen levels in healthy postmenopausal women who either use or do not use hormone replacement therapy (HRT). Plasma fibrinogen levels were measured in 20 physically active (56 +/- 1 yr) and 31 sedentary (58 +/- 1 yr) healthy postmenopausal women. Nine (45%) physically active and 15 (48%) sedentary women had been using HRT for > 1 year; the others were nonusers of HRT. Plasma fibrinogen levels were approximately 15% lower (p = .001) in the physically active women (2.48 +/- .08 g/L) than the sedentary controls (2.92 +/- .06 g/L) and approximately 7% lower (p = .04) in the users (2.65 +/- .08 g/L) versus nonusers (2.84 +/- .08 g/L) of HRT. Moreover, the lower (0.4 g/L) plasma fibrinogen levels associated with regular physical activity were evident in both the users (2.39 +/- .11 vs 2.80 +/- .08 g/L, p = .001) and nonusers (2.56 +/- .11 vs 3.03 +/- .08 g/L, p = .006) of HRT. Stepwise multiple regression analysis revealed that percent body fat was the primary determinant of plasma fibrinogen levels, accounting for 30% of the variability. Regular physical activity is associated with lower plasma fibrinogen levels in postmenopausal women; the lower plasma fibrinogen levels associated with regular physical activity are evident in both users and nonusers of HRT; and plasma fibrinogen levels are positively related to percent body fat in postmenopausal women differing in physical activity and HRT status. Lower plasma fibrinogen levels in physically active postmenopausal women may contribute to their lower risk of cardiovascular disease.

MAXIMAL EXERCISE CARDIOVASCULAR HEMODYNAMICS IN POSTMENOPAUSAL WOMEN ARE INDEPENDENT OF HORMONE REPLACEMENT THERAPY 62

We examined the effects of different levels of physical activity (PA) and hormone replacement therapy (HRT) on cardiovascular (CV) hemodynamics during maximal exercise in postmenopausal women (64 ± 5 yr). Fourteen sedentary women (SED), 20 PA women, and 17 athletic women (ATH) were studied; 24 women were on HRT and 27 women were not on HRT. Data were collected for body composition (DEXA), VO2max, and cardiac output (acetylene rebreathing) during maximal exercise. HRT status was unrelated to body composition or any of the CV parameters at maximal exercise. ATH had greater maximal cardiac outputs due to higher stroke volumes (SV) and lower total peripheral resistance (TPR) than PA or SED. Table Activity level did not affect SBP or DBP. These data indicate that CV hemodynamics during maximal exercise in postmenopausal women are affected by PA status but are independent of HRT status.

No Association of Menopause and Hormone Replacement Therapy With Carotid Artery Intima-Media Thickness

Cardiovascular disease is the major cause of death in older women. Information on the relation of menopause and hormone replacement therapy with carotid atherosclerosis is limited. We examined cross-sectionally the association of menopausal status, years since last menstruation, and hormone replacement therapy status with carotid artery intima-media thickness as determined by B-mode ultrasound. Female participants (n = 5436) in the Atherosclerosis Risk in Communities Study without a history of symptomatic cardiovascular disease were included in the analyses. Menopause status in 45- to 54-year-old women who had never used hormone replacement therapy was not strongly associated with carotid intima-media thickness (mean = 0.65 mm and 0.67 mm in premenopausal and postmenopausal women, respectively, adjusted for age, race, cigarette years of smoking, body mass index, sport index, systolic blood pressure, use of blood pressure medications, drinking status, diabetes, and education level). In postmenopausal women aged 55 to 64 years, women with < or = 5 years since last menstruation had an adjusted average intima-media thickness (0.74 mm) comparable to those with > 5 years since last menstruation (0.75 mm) (P > .05). Although hormone replacement therapy use was associated with a more favorable lipid and hemostasis profile than nonuse, its use was not associated with intima-media thickness in postmenopausal women aged 55 to 64 years (adjusted average = 0.74 mm for current users of estrogen alone and approximately 0.75 mm each for current users of estrogen plus progestin, former users, and never users). The data suggest that the well-known associations of hormone replacement therapy with reductions in atherosclerotic cardiovascular disease may be attributable more to acute physiological effects, such as hemodynamic changes or reduced thrombosis, than to atherosclerosis itself.

Relation of hormone and menopausal status to outcomes following excimer laser photorefractive keratectomy in women. Melbourne Excimer Laser Group.

To examine the effect of hormone use, pregnancy and menopausal status on clinical outcomes following excimer laser surgery for myopia and myopic astigmatism. Participants comprised all female patients of the Melbourne Excimer Laser Group (MELG). A standardised surgical protocol was followed by the 27 MELG members, using the VisX 20/20 excimer laser and included the prospective collection of the following information preoperatively and one, three, six and 12 months after the procedure: uncorrected and best corrected visual acuity with a LogMAR chart; best manifest refraction; and subjective assessment of corneal clarity. A survey that elicited information about oral contraceptive (OC) use, pregnancy history, surgical and natural menopause, and use of hormone replacement therapy (HRT) was mailed to all the women. A 77% response to the mailed survey was achieved. Two women were pregnant at the time of surgery, one became pregnant during the first month after surgery, and all three women were excluded from further analyses, although a review of two of the case histories revealed suboptimal clinical outcomes. Women taking OC were included in the control group after OC use was shown not to be associated with outcome. Women were grouped accordingly: control, n = 225, pre-menopausal on HRT, n = 7, post-menopausal not on HRT, n = 34; and post-menopausal on HRT, n = 21. The groups differed significantly with regard to age and preoperative spherical equivalent. After controlling for age and preoperative spherical equivalent, the mean number of uncorrected LogMAR letters read one year after surgery was significantly lower for the post-menopausal women on the HRT in comparison with the control group. Best corrected acuity and corneal clarity were not significantly different among the groups. These preliminary results suggest that the interaction of menopausal and HRT status could decrease the effectiveness of PRK and PARK, but require confirmation with a further study in a prospective manner using objective measures of corneal epithelial healing and serum hormone levels.