Resumen

VELAZQUEZ-MALDONADO, Elsy M.; MENDOZA, Soaira  y  ARATA DE BELLABARBA, Gabriela. Efectos de dos esquemas de TH combinada cíclica sobre la presión arterial, lipoproteínas, índices de resistencia a la insulina y cociente TG/C-HDL en mujeres posmenopáusicas hipertensas. Rev. Venez. Endocrinol. Metab. [online]. 2007, vol.5, n.2, pp.3-7. ISSN 1690-3110.

Abstract Objectives: To compare the effect of two routes of hormonal therapy (HT) on blood pressure, insulin resistance indexes, Tg/ HDL-C ratio in postmenopausal hypertensive women. Méthods: A clinical study was performed in 19 postmenopausal women. All women were treated with equine conjugated estrogens (Premarin®: 0,625mg) for 8 weeks (O-HT). After 4 weeks period without treatment, patients were switched to transdermal estrogen therapy (TD-HT) using 17βestradiol (Estraderm®, 50mg). Medroxyprogesterone (5mg, Provera®) acetate was administered during 3rd-4th week and seventh-eighth week in each treatment cycle. Blood pressure and blood samples were taken at baseline and after each period o treatment. Laboratory protocol included determinations of FSH, estradiol, androstendione, DHEAS and glucose and insulin during a standard oral glucose test. Results: HT caused a significant decrease in BP but TD-HT was more efficient (p<0,05). Oral treatment was associated with a significant decrease in Tg/C-HDL, Ct/C-HDL indexes and a significant increase in HDL-C. Plasma Tg decreased significantly after both routes of treatment with more pronounced effect during TD-HT. No significant differences between groups were observed in plasma glucose and insulin during fasting and post oral glucose load. TD-HT showed a significant decrease in HOMA-IR and a significant increase in sensitivity indexes QUICKI and ISI. Serum androstenedione levels were decreased after both routes of treatment (p<0,05). Conclusions: Combined cyclical HT has beneficial effects on blood pressure, lipoproteins, Tg/C-HDL ratio and insulin action indexes leading to a lower risk of cardiovascular disease in postmenopausal hypertensive women. We suggest that in this population, transdermal HT should be considered as a first therapeutic option.

Palabras clave : hormonal therapy; blood pressure; lipoproteins; insulin action indexes; postmenopausal hypertensive.