OBJECTIVE: To determine whether blood pressure (BP) responses to pressor stimuli during hormone replacement therapy are reduced by oral conjugated equine estrogens 0.625 mg/day (ERT) and ERT in combination with 5 mg/day continuous medroxyprogesterone (HRT) in women with and without type 2 diabetes. METHODS:Twenty type 2 diabetic and 20 non-diabetic women completed a three period, randomised, double bind crossover studying the effects of 1 month of therapy of ERT, HRT and placebo on BP responses to mental arithmetic and isometric stress and to intravenous infusions of noradrenaline and angiotensin II. RESULTS: Significant differences were found between the effects of ERT, HRT and placebo therapy on BP responses to mental arithmetic in the women with type 2 diabetes apparently due to a smaller response during ERT therapy. BP responses to mental arithmetic were not affected in non-diabetic women. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II were similar in the type 2 diabetic and non-diabetic women and were not affected by ERT or HRT therapy. Plasma renin activity differed significantly between ERT, HRT and placebo therapies in type 2 diabetic women, apparently because of lower levels during ERT and HRT therapy. CONCLUSIONS:ERT and HRT may produce beneficial effects on BP responses to psychological stress and on plasma renin activity in women with type 2 diabetes. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II are not altered by ERT or HRT in type 2 diabetic or non-diabetic women.
RCT Entities:
OBJECTIVE: To determine whether blood pressure (BP) responses to pressor stimuli during hormone replacement therapy are reduced by oral conjugated equine estrogens 0.625 mg/day (ERT) and ERT in combination with 5 mg/day continuous medroxyprogesterone (HRT) in women with and without type 2 diabetes. METHODS: Twenty type 2 diabetic and 20 non-diabeticwomen completed a three period, randomised, double bind crossover studying the effects of 1 month of therapy of ERT, HRT and placebo on BP responses to mental arithmetic and isometric stress and to intravenous infusions of noradrenaline and angiotensin II. RESULTS: Significant differences were found between the effects of ERT, HRT and placebo therapy on BP responses to mental arithmetic in the women with type 2 diabetes apparently due to a smaller response during ERT therapy. BP responses to mental arithmetic were not affected in non-diabeticwomen. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II were similar in the type 2 diabetic and non-diabeticwomen and were not affected by ERT or HRT therapy. Plasma renin activity differed significantly between ERT, HRT and placebo therapies in type 2 diabeticwomen, apparently because of lower levels during ERT and HRT therapy. CONCLUSIONS:ERT and HRT may produce beneficial effects on BP responses to psychological stress and on plasma renin activity in women with type 2 diabetes. BP responses to isometric exercise and to intravenous infusions of noradrenaline and angiotensin II are not altered by ERT or HRT in type 2 diabetic or non-diabeticwomen.
Authors: Shelley R Salpeter; Judith M E Walsh; Elizabeth Greyber; Thomas M Ormiston; Edwin E Salpeter Journal: J Gen Intern Med Date: 2004-07 Impact factor: 5.128