Efeito da terapia estrogênica de curta duração sobre a função endotelial de mulheres climatéricas: ensaio clínico duplo-cego, randomizado e controlado com placebo

• Ano de defesa: 2015
• Autor(a) principal: Rodrigo Hurtado
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Menopausa; Função endotelial; Terapia hormonal estrogênica; Dilatação fluxomediada da artéria braquial; Climatério; Endotélio vascular/fisiologia; Artéria braquial; Terapia de reposição de estrogênios; Dilatação/métodos
• Link de acesso: http://hdl.handle.net/1843/BUBD-9ZCNH7

BACKGROUND: The population´s life expectancy has increased considerably over the last decades resulting in a significant share of women which will experience at least a third of their lifespan after menopause. This particular period of life is characterized by metabolic changes secondary to estrogen deprivation, such as a poor lipid profile and loss of vascular endothelial dilation with a resulting increase of cardiovascular risk. Estrogen therapy was proven efficient in reversing these estrogen deprivation features in both laboratory and animal studies but there is still no consensus to which hormone therapy, dosage, administration path and time of onset would be optimal for reducing cardiovascular risk and also safe for clinical use. OBJECTIVE: To detect through Flow Mediated Dilation (FMD) whether or not short term estrogen therapy is able to promote endothelial dependent vasodilation in menopausal women. METHODS: In this double-blinded, placebo controlled RCT, 64 menopausal women were assigned into two groups: short term treatment using 0,625mg of Conjugated Estrogens in the study group and placebo in the control group. FMD was measured before and after 28 days of medication and the results were compared to determine any significant difference between the groups. RESULTS: FMD results showed endothelial dependent dilation in the estrogen therapy group (FMD = 1.1%) as opposed to the placebo group (FMD = -8.2%). A statistically significant difference was demonstrated by Mann-Whitney´s statistical test (p=0,025). The two groups were also evaluated for homogeneity in respect to variables that could interfere with endothelial function such as age, Body Mass Index (BMI), time since menopause, chronic vascular conditions, and personal habits (smoking, exercise). There was no statistical difference between the groups for any of these variables. CONCLUSION: The use of 0,625mg of conjugated estrogens for only 28 days is effective in promoting endothelial dependent vascular dilation, assessed by FMD in menopausal women.