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Estrogen Increases Hyperemic Microvascular Blood Flow Velocity in Postmenopausal Women

^a Division of Geriatrics and Gerontology, Washington University School of Medicine, St. Louis, Missouri.
^b Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri.
^c Appleton Heart Institute, Appleton, Wisconsin.

Linda R. Peterson, Cardiovascular Division, Washington University School of Medicine, Campus Box 8086, 660 S. Euclid Avenue, St. Louis, MO 63110 E-mail: lpeterso{at}imgate.wustl.edu.

Decision Editor: William B. Ershler, MD

Background. Epidemiologic studies suggest that estrogen replacement therapy (ERT) is protective against vascular disease. ERT confers this benefit by lowering lipid levels and improving arterial function. However, its effect on the microvasculature in vivo is unknown. Thus the purposes of this study were to evaluate effect of estrogen status on the hyperemic response of the microvasculature in vivo in postmenopausal women and to compare the hyperemic response of the microvasculature in postmenopausal women taking ERT with that of premenopausal women.

Methods. We measured forearm microvasculature flow velocity by using a laser Doppler in a cross section of 64 healthy premenopausal and postmenopausal women 23 to 72 years old. Microvasculature blood flow velocity was measured at baseline, throughout 2 minutes of ischemia, and immediately after the ischemic period was terminated (i.e., during the peak hyperemic response).

Results. The peak of the hyperemic flow velocity (PHFV) in the postmenopausal women who were taking long-term ERT at usual doses was greater than that of postmenopausal women who were not currently taking ERT (p < .0001). Moreover, the PHFV of postmenopausal women taking ERT was similar to that of premenopausal women. Multivariate regression analysis showed estrogen status and baseline flow velocity to be independent predictors of PHFV.

Conclusions. Current, long-term ERT at usual replacement doses is associated with improved microvascular responses in postmenopausal women, which may explain some of its beneficial vascular effects.