A new study from Dr. Kenna Stephenson’s laboratory at the University of Texas Health Science Center, Tyler, Texas in collaboration with ZRT laboratory in Beaverton, Oregon on the role of estrogen and progesterone in hypertension in menopausal women, will be presented at the 63rd High Blood Pressure Research Conference 2009 (Sept. 23- 26, 2009) in Chicago. I will be at the conference along with Dr. Kenna Stephenson to present this data. The study shows that luteal phase levels of progesterone and estrogen via transdermal delivery improve blood pressure in perimenopausal and menopausal women with prehypertension and job/ home strain.
Perimenopausal transition and menopause have been associated with hypertension but the underlying reasons for increased risk for high blood pressure in these women is not very clear. Several different factors like weight gain, loss of energy, depression, alcohol consumption, job/ home stress have been linked with increased risk for high blood pressure in menopausal and postmenopausal women. Women with high job/home strain are more vulnerable to hypertension, and the clustering effect of metabolic changes, inflammation, dysphoria, and high perceived stress are emerging as gender specific attributes of cardiovascular disease in women.
It is believed that during menopause, the circulating estrogen levels fall and the interplay of progesterone and estrogen levels increases the overall risk of hypertension in women. This new study from Dr. Stephenson’s laboratory involving experimental females demonstrate the profound impact of luteal phase progesterone and estrogen levels on endothelial function, vascular smooth muscle tone, and optimal homeostatic regulation. The effects of mimicking luteal phase progesterone/estrogen ratios on blood pressure and gender specific biomarkers in peri/postmenopausal were investigated.
70 women (mean age 51.9 years) who met strict inclusion/exclusion criteria were treated with transdermal progesterone and estrogen titrated to physiological luteal phase reference ranges. Subjects were required to abstain from food or beverage for 10 hours prior to visits. After resting for 30 minutes in a quiet room, blood pressure was measured at the brachial artery using a validated semi-automated oscillometric sphygomonamometer.
It was observed that while the overall life strain in these women was high and remained high for 8 weeks, transdermal progesterone and estrogen treatment caused significant reduction in blood pressure; progesterone and PG/E ratios were also significantly elevated.
Recognizing the critical role of sex steroids in the vasculopathology of perimenopausal and menopausal women may provide a plausible gender specific approach to prehypertension. Whereas conventional hormone therapies have been shown to increase blood pressure and cardiovascular disease risk in women, findings from this study reveal that appropriate modulation of the hormonal milieu via transdermal physiological sex steroid therapy lowers blood pressure and may potentially buffer the adverse effects of high perceived stress and strain without inducing adverse effects on cardiovascular biomarkers.