Cited by 207Menopause: Health Impacts and TreatmentsHormonal and reproductive studiesEstrogen and related hormone effects

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Cardiovascular Effects of Physiological and Standard Sex Steroid Replacement Regimens in Premature Ovarian Failure

Langrish, Jeremy P., Mills, Nicholas L., Bath, Louise E., Warner, Pamela, Webb, David J., Kelnar, Christopher J., Critchley, Hilary O.D., Newby, David E., Wallace, W. Hamish B.·2009·Hypertension

DOI 10.1161/hypertensionaha.108.126516

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Abstract

Current hormone replacement therapy may not optimize cardiovascular health in women with premature ovarian failure. We compared the effects of physiological and standard sex steroid replacement regimens on cardiovascular health in these women. In an open-label, randomized, controlled crossover trial, 34 women with premature ovarian failure were randomly assigned to 4-week cycles of physiological (transdermal estradiol and vaginal progesterone) and standard (oral ethinylestradiol and norethisterone) therapy for 12 months. Cardiovascular health was assessed by 24-hour ambulatory blood pressure, arterial stiffness, and renal and humoral factors. Eighteen women (19 to 39 years of age) completed the 28-month protocol. Both regimens caused similar suppression of luteinizing hormone and follicle-stimulating hormone and provided symptom relief. In comparison with the standard regimen, physiological sex steroid replacement caused lower mean 24-hour systolic and diastolic blood pressures throughout the 12-month treatment period (ANOVA; P ≤0.0001 for both): systolic blood pressure was 7.3 mm Hg (95% CI: 2.5 to 12.0 mm Hg) and diastolic was 7.4 mm Hg (95% CI: 3.9 to 11.0 mm Hg) lower at 12 months. Although there were no differences in arterial stiffness, physiological sex steroid replacement reduced plasma angiotensin II (ANOVA; P =0.007) and serum creatinine (ANOVA; P =0.015) concentrations without altering plasma aldosterone concentrations. In comparison with a standard regimen, physiological sex steroid replacement in women with premature ovarian failure results in lower blood pressure, better renal function, and less activation of the renin-angiotensin system. These findings have major implications for the future cardiovascular health of young women who require long-term sex steroid replacement therapy.

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Additional file 1 of Effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women: a systematic review and meta-analysis
Yang, D., Tao, S., 邵明晶, Huang, L., Xiao, X., Zhang, J., Yao, R., & Sun, Z. (2024) · Figshare · doi:10.6084/m9.figshare.26157115
Additional file 1 of Metabolic differences in women with premature ovarian insufficiency: a systematic review and meta-analysis
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Additional file 2 of Effectiveness of exercise training on arterial stiffness and blood pressure among postmenopausal women: a systematic review and meta-analysis
Yang, D., Tao, S., 邵明晶, Huang, L., Xiao, X., Zhang, J., Yao, R., & Sun, Z. (2024) · Figshare · doi:10.6084/m9.figshare.26157377
Additional file 3 of Metabolic differences in women with premature ovarian insufficiency: a systematic review and meta-analysis
Cai, W.-Y., Luo, X., Wu, W., Song, J., Xie, N.-N., Duan, C., Wu, X.-K., & Xu, J. (2022) · Figshare · doi:10.6084/m9.figshare.21256870
Additional file 2 of Metabolic differences in women with premature ovarian insufficiency: a systematic review and meta-analysis
Cai, W.-Y., Luo, X., Wu, W., Song, J., Xie, N.-N., Duan, C., Wu, X.-K., & Xu, J. (2022) · Figshare · doi:10.6084/m9.figshare.21256867
Additional file 4 of Metabolic differences in women with premature ovarian insufficiency: a systematic review and meta-analysis
Cai, W.-Y., Luo, X., Wu, W., Song, J., Xie, N.-N., Duan, C., Wu, X.-K., & Xu, J. (2022) · Figshare · doi:10.6084/m9.figshare.21256873
Primary ovarian insufficiency
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Authors: Langrish, J. P., Mills, N. L., Bath, L. E., Warner, P., Webb, D. J., Kelnar, C. J., Critchley, H. O. D., Newby, D. E., & Wallace, W. H. B.
Affiliations: University of Edinburgh (GB)
ORCID: Mills, Nicholas L.
Warner, Pamela
Webb, David J.
Critchley, Hilary O.D.
Newby, David E.
Wallace, W. Hamish B.
Venue: Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-05
Volume: 53
Issue: 5
Pages: 805-811
ISSN: 0194-911X (ISSN-L)
1524-4563
DOI: 10.1161/hypertensionaha.108.126516
OpenAlex: W2161581155
Cited by: 207
References: 37
Citations by year: 2026: 12 · 2025: 7 · 2024: 16 · 2023: 15 · 2022: 20 · 2021: 16 · 2020: 16 · 2019: 20 · 2018: 16 · 2017: 15 · 2016: 10 · 2015: 6 · 2014: 4 · 2013: 5 · 2012: 9
FWCI: 7.02
Type: journal article
Language: en
Open access: closed
Locations: Hypertension (publishedVersion)
PubMed (publishedVersion)
Funders: British Heart Foundation (FS/07/048)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
Keywords: premature ovarian failure, sex hormone replacement therapy, transdermal estradiol, vaginal progesterone, ethinyl estradiol, norethisterone, cardiovascular health, blood pressure, arterial stiffness, renin-angiotensin system, angiotensin II, aldosterone, renal function, luteinizing hormone suppression, follicle-stimulating hormone
MeSH terms: Adult, Arteries, Blood Pressure, Female, Humans, Estrogen Replacement Therapy, Primary Ovarian Insufficiency, Cross-Over Studies, Blood Pressure Monitoring, Ambulatory

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Cardiovascular Effects of Physiological and Standard Sex Steroid Replacement Regimens in Premature Ovarian Failure

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