Acute effects of the use of estrogens in association with progestogens on postprandial triglyceridemia and vascular reactivity.

OBJECTIVE To assess whether hormone replacement therapy with estrogens in association with progestogens in postmenopausal hypertensive women alters postprandial triglyceridemia and vascular reactivity. METHODS A double-blind, placebo-controlled, crossover study was carried out with 15 postmenopausal women (age range: 50 to 70 years, mean = 61.6 +/- 6 years) randomly assigned to 2 weeks of placebo or oral ingestion of 0.625 mg of equine conjugated estrogens and 2.5 mg of medroxyprogesterone, fed a high-fat diet (897 calories; 50.1% fat). Vascular reactivity (VR - % of vessel diameter variation in the fasting period and 2 hours after meals) was measured by using the automated ultrasound method. Lipid profile and glycemia during the fasting period and 2 hours after a high-fat meal were measured. RESULTS With placebo, vascular reactivity (VR) decreased from 3.20 +/- 17% during the fasting period to -2.1 +/- 30% 2 hours after the meal (P = 0.041). With the hormone replacement therapy, vascular reactivity decreased from 6.14 +/- 27% during the fasting period to - 0.05 +/- 18% 2 hours after the meal (P = NS). Postprandial triglyceridemia increased as follows: 35 +/- 25% with placebo; and 12 +/- 10% with hormone replacement therapy (P < 0.05). CONCLUSION In postmenopausal hypertensive women, 2 weeks of hormone replacement with an association of estrogens and progestogens decreased hypertriglyceridemia after a high-fat meal, an effect that may reduce the endothelial dysfunction occurring in the postprandial period.