Hormone replacement use, arterial distensibility, cardiac structure and circadian blood pressure profile in menopausal women.

Observational and interventional studies that evaluate the impact of hormone replacement therapy (HRT) on cardiovascular changes have produced inconsistent and inconclusive results. The present study sought to elucidate the influence of HRT on aortic distensibility, left ventricular mass (LVM) and 24-h blood pressure (BP) profile in 38 menopausal women who were either HRT users or non-users. The two groups were similar for age, ambulatory BP, aortic distensibility, cardiac mass, lipid profile and body mass index but differed in clinic diastolic BP (DBP). HRT non-dippers had significantly lower clinic and daytime DBP and a smaller nocturnal BP reduction than dippers. Daytime DBP was significantly and inversely related to duration of HRT use. The present study demonstrates that hormonal therapy after menopause lowers DBP, but shows no significant influence on aortic distensibility, cardiac mass or 24-h BP profile. HRT users who were dippers demonstrated a significantly greater nocturnal BP reduction. Long-term controlled trails are needed to better define the effects of estrogen and progestin on the aorta, the heart and 24-h BP profile in normotensive and hypertensive menopausal women.