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Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women.
Am Heart J. 2005 Feb; 149(2):291-7.AH

Abstract

BACKGROUND

Both exercise and postmenopausal estrogen therapy augment endothelial function. We hypothesized that their interaction would be additive. The study objectives were to determine in postmenopausal women (1) the effects of an acute bout of exercise on brachial artery endothelium-dependent flow-mediated vasodilation (FMD), (2) whether these responses to exercise are augmented by concurrent estrogen treatment, and (3) whether these 2 interventions, independently or together, achieve FMD values observed in premenopausal women.

METHODS

In postmenopausal women (n = 13; age 54 +/- 2 [mean +/- SE] years), FMD was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes at 60% V* O2max. Subjects were studied twice: before and after 4 weeks of oral estradiol. To obtain reference normal values, FMD was determined concurrently in 14 premenopausal (28 +/- 1 years) women under identical basal conditions.

RESULTS

Flow-mediated vasodilation in postmenopausal women, markedly impaired when compared with premenopausal women (5.3% +/- 0.5% vs 12.1% +/- 1.5%, P < .01), was significantly increased by exercise (to 9.9% +/- 0.6%, P < .01). In contrast, after estrogen, FMD was augmented at rest (P < .01) but was not further enhanced after exercise (11.5% +/- 0.6% vs 9.9% +/- 0.5%, P = .3). Both interventions increased, independently, FMD to values in premenopausal women (P > .05).

CONCLUSIONS

In postmenopausal women, both acute exercise and estrogen therapy normalize FMD. However, their effects are not additive, possibly because of redundancy of nitric oxide signaling pathways activated by these 2 interventions. When considered in the context of recent trials with adverse cardiovascular outcomes, these results reinforce the therapeutic potential of exercise as an alternative nonpharmacological intervention to estrogen in postmenopausal women with endothelial dysfunction.

Authors+Show Affiliations

Harvey PJ
Division of Cardiology, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada. paula.harvey@uhn.on.ca
Picton PE
No affiliation info available
Su WS
No affiliation info available
Morris BL
No affiliation info available
Notarius CF
No affiliation info available
Floras JS
No affiliation info available

MeSH

Administration, OralBlood PressureBrachial ArteryCholesterolEndothelium, VascularEstradiolEstrogen Replacement TherapyExerciseFemaleHeart RateHumansMiddle AgedNitric OxidePostmenopauseTriglyceridesVasodilation

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15846267

Citation

Harvey, Paula J., et al. "Exercise as an Alternative to Oral Estrogen for Amelioration of Endothelial Dysfunction in Postmenopausal Women." American Heart Journal, vol. 149, no. 2, 2005, pp. 291-7.
Harvey PJ, Picton PE, Su WS, et al. Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women. Am Heart J. 2005;149(2):291-7.
Harvey, P. J., Picton, P. E., Su, W. S., Morris, B. L., Notarius, C. F., & Floras, J. S. (2005). Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women. American Heart Journal, 149(2), 291-7.
Harvey PJ, et al. Exercise as an Alternative to Oral Estrogen for Amelioration of Endothelial Dysfunction in Postmenopausal Women. Am Heart J. 2005;149(2):291-7. PubMed PMID: 15846267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women. AU - Harvey,Paula J, AU - Picton,Peter E, AU - Su,Winnie S, AU - Morris,Beverley L, AU - Notarius,Catherine F, AU - Floras,John S, PY - 2005/4/23/pubmed PY - 2005/9/24/medline PY - 2005/4/23/entrez SP - 291 EP - 7 JF - American heart journal JO - Am Heart J VL - 149 IS - 2 N2 - BACKGROUND: Both exercise and postmenopausal estrogen therapy augment endothelial function. We hypothesized that their interaction would be additive. The study objectives were to determine in postmenopausal women (1) the effects of an acute bout of exercise on brachial artery endothelium-dependent flow-mediated vasodilation (FMD), (2) whether these responses to exercise are augmented by concurrent estrogen treatment, and (3) whether these 2 interventions, independently or together, achieve FMD values observed in premenopausal women. METHODS: In postmenopausal women (n = 13; age 54 +/- 2 [mean +/- SE] years), FMD was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes at 60% V* O2max. Subjects were studied twice: before and after 4 weeks of oral estradiol. To obtain reference normal values, FMD was determined concurrently in 14 premenopausal (28 +/- 1 years) women under identical basal conditions. RESULTS: Flow-mediated vasodilation in postmenopausal women, markedly impaired when compared with premenopausal women (5.3% +/- 0.5% vs 12.1% +/- 1.5%, P < .01), was significantly increased by exercise (to 9.9% +/- 0.6%, P < .01). In contrast, after estrogen, FMD was augmented at rest (P < .01) but was not further enhanced after exercise (11.5% +/- 0.6% vs 9.9% +/- 0.5%, P = .3). Both interventions increased, independently, FMD to values in premenopausal women (P > .05). CONCLUSIONS: In postmenopausal women, both acute exercise and estrogen therapy normalize FMD. However, their effects are not additive, possibly because of redundancy of nitric oxide signaling pathways activated by these 2 interventions. When considered in the context of recent trials with adverse cardiovascular outcomes, these results reinforce the therapeutic potential of exercise as an alternative nonpharmacological intervention to estrogen in postmenopausal women with endothelial dysfunction. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/15846267/Exercise_as_an_alternative_to_oral_estrogen_for_amelioration_of_endothelial_dysfunction_in_postmenopausal_women_ DB - PRIME DP - Unbound Medicine ER -