Changes in vascular wall stiffness and central aortic pressure in women of early post-menopausal period and the possibilities of correction of the revealed disturbances
Year: 2017, volume 13 Issue: №1 Pages: 034-041
Heading: Internal Diseases Article type: Original article
Authors: Tolstov S.N., Salov I.A., Rebrov A.P.
Organization: Saratov State Medical University
Heading: Internal Diseases Article type: Original article
Authors: Tolstov S.N., Salov I.A., Rebrov A.P.
Organization: Saratov State Medical University
Summary:
Measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system than the only stiffness of the vascular wall. The purpose of the study is to assess the changes of indicators of central aortic pressure and arterial stiffness in women of early postmenopausal period, against the background of the prolonged use of menopausal hormone therapy 1 mg E2 / 2mg DRSP. Material and Methods. The study included 162 women in early postmenopause. The subjects were divided into 2 groups: primary — 84 patients, which was appointed menopausal hormone therapy 1 mg E2 / 2mg of DRSP (drug "Angelique", Bayer), control group — 78 women who did not receive menopausal hormone therapy. The duration of observation is 5.2 years. ABPM was performed with the evaluation indicators of arterial stiffness (RWTT, Alx, ASI, AASI, (dP/dt) max.), central aortic pressure, aoPW. Results. Initial aoPW increase was detected in 15 (21.4%) women of the main group and in 19 (24.3%) control group patients (p=0,4). The women in both groups showed an increase to the end of the study aoPW more pronounced in women of control group. Increasing falls detected in 25 (29.7%) women of the main group and in 25 (32%) women of control group (p=0.84). It was noted that in women in both groups a significant decrease of central aortic pressure has been matched. In women of the main group to the end of the study there was a reduction in pulse pressure from 38,4±6,2 to 35,3±4,19mm Hg (p<0,001) and the absence of changes in women drops the control group. It is noted a significant increase of Alxao in patients of control group and no change in women of the main group. ASI revealed a decrease in women of the main group with 132.0 (121.0; 142.0) to 127.0 (115.5; 137.0) to the end of the study, and an increase from 133.0 (111.0; 155.0) to 148.0 (134.2; 171.0) in women in the control group (p<0.01). Decrease of AASI in women of the main group to 0.379 (0.320; 0.463) to 0.264 (0.203; 0.329), (p<0.001)and no change in the control group of women has been detected. Conclusion. The measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system. The positive changes in arterial stiffness and reflected waves, determining the value of central aortic pressure, on the background of long-term menopausal hormone therapy combined 1 mg E2 / 2 mg DRSP.
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