ESTROGEN and YOUR BLOOD PRESSURE DURING HRT : A possibility? Perhaps. Any kind of measurable risk? NO!!! Especially not with Transdermal Estradiol As with much information from a decade or two ago that is blindly repeated by the medical profession and various organization guidelines and standards, the issue of BLOOD PRESSURE is often turned into a scare tactic. Despite the known fact that Menopause is accompanied by a dramatic rise in the prevalence of hypertension in women, suggesting a protective role of endogenous estradiol on blood pressure (BP)...... ..there is ongoing concern by published organizational guidelines of various kinds that somehow estrogen might cause HIGH blood pressure during HRT...without sufficient concern about just what is being used for that HRT. What these two studies, which as often is the case, were conducted in GG women of menopausal and post menopausal age show us clearly is that: The oral estrogens that were used prior to these years (which were generally NOT bio-identical estradiol by toxic synthetics) along with the various cockamie progestins were responsible for elevation of blood pressure. When transdermal estradiol was used (because it happened to be natural bio-identical estradiol) there was, if anything, a modest improvement in blood pressure. Period! Beware of standards published without consideration of these studies. Curr Hypertens Rep. 2006 Oct;8(5):368-76. ESTROGEN AND HYPERTENSION Divisions of Hypertension, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, J4 134, Dallas, TX 75390-8586, USA. Menopause is accompanied by a dramatic rise in the prevalence of hypertension in women, suggesting a protective role of endogenous estradiol on blood pressure (BP). Both animal experimental and human clinical investigations suggest that estrogen engages several mechanisms that protect against hypertension, such as activation of the vasodilator pathway mediated by nitric oxide and prostacyclin and inhibition of the vasoconstrictor pathway mediated by the sympathetic nervous system and angiotensin. However, emerging evidence from recent clinical trials indicates a small increase, rather than decrease, in systolic BP with oral estrogen administration in postmenopausal women, without any detectable effect on diastolic BP. Mechanisms underlying this selective rise in systolic BP in postmenopausal women and oral contraceptive-induced hypertension in premenopausal women remain unknown, but the rise may be related to supraphysiologic concentration of estrogen in the liver (NOTE: More probably these findings were not as much due to the oral administration as to the fact that orals...(and contraceptives) were NOT bio-identical but contained synthetic estrogens and bio-identical estradiol and likely also various weird progestins and not progesterone) To date, TRANSDERMAL DELIVERY of estrogen, which avoids the first-pass hepatic metabolism of estradiol, APPEARS TO HAVE SMALL BP-LOWERING effect in postmenopausal women and may be a safer alternative in hypertensive women. ncbi.nlm.nih.gov/pubmed/16965722 Climacteric. 2009;12 Suppl 1:66-70. Comparative effects HRT on BLOOD PRESSURE in POST MENOPAUSAL WOMEN Division of Clinical Pharmacology, Department of Medicine, Miller School of Medicine, University of Miami, Florida 33136, USA. Menopause is commonly characterized by an increase in blood pressure. There is a graded relationship between blood pressure and cardiovascular risk which extends to levels of blood pressure well below 140/90 mmHg, the classical established blood pressure limit for the diagnosis of hypertension. It is clear that novel and innovative population strategies for lowering blood pressure in postmenopausal women are warranted. Clinical trials suggest that oral estrogen administration may produce either a neutral effect or a small increase in blood pressure in postmenopausal women. TRANSDERMAL ESTROGEN ADMINISTRATION HAS NOT BEEN STUDIED AS EXTENSIVELY BUT MAY PRODUCE A DECREASE IN BLOOD PRESSURE. The mechanisms for the differences observed between oral and transdermal estrogen have not been completely elucidated. (NOTE: Thats probably because they didnt backtrack and note that most oral estrogens in those older studies were NOT bio-identical estradiol while the transdermal administration WAS BIO-IDENTICAL ESTRADIOL so the difference were very likely due to the synthetic molecular nature of the estrogen and not the route of administration.. as has been shown in other studies dealing with venous thrombosis..based on the same failure to distinguish the molecular nature or oral vs transdermal used in those older studies) ncbi.nlm.nih.gov/pubmed/19811245
Posted on: Thu, 27 Feb 2014 04:26:52 +0000
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