Efeitos agudos dos estrogênios associados a progestogênios sobre a trigliceridemia e reatividade vascular pós-prandial

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=O.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). Post-prandial 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.