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Volume 3 No. 4, October 2008 |
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Exercise As a Non Pharmacological Intervention and Alternative to Oral Estrogen Therapy in Post Menopausal Women with Endothelial Dysfunction Samia Sharaf Eldeen(1), Lamia Al-Ahowal(2), Abeer Shahba(3), Mervat El-Sergany(4), Maessa M. Elnahas(5) & Enas Elbendary(5)
Department of cardiology(1),
Obstetric and gynecology(2),
internal medicine(3),
Rehabilitation and
Rheumatology(4),and
Physiology(5),
faculty of medicine Tanta University.
Background/Aim: Both exercise and postmenopausal estrogen therapy
augment endothelial function through increasing bioavailability of
nitricoxide (NO). The aim of this study was to: 1- determine the
effects of acute bouts of exercise on brachial artery endothelium
dependent flow mediated vasodilatation FMD in postmenopausal women.
2- Whether these responses were augmented by the concurrent use of
oral estrogen. 3- Whether these two interventions independently or
together achieve FMD values observed in pre menopausal women.
Patients & Methods: This study was conducted on 30 apparently
healthy post menopausal women their mean of age was [54 + 4 years
old]. FMD was quantified during supine rest and again 60 minutes
after treadmill exercise for 45 minute at 60% v02 max – subjects
were studied twice, before and after 4 weeks of oral estradiol. The
normal reference values was obtained from concurrent determinant of
FMD in 30 pre menopausal women their mean of age was (28 + 2) years
old under identical basal conditions. Results: flow mediated
vasodilatation in post menopausal women markedly impaired when
compared with pre menopausal women. The mean of absolute diameter
change in brachial artery for flow mediated dilatation in post
menopausal women was significantly less than premenopausal women
[2.01 + 0.2mm (6.1%) Vs 4.1 + 0.4mm (12%) P<0.05]. After exercise
the absolute change in the brachial artery diameter for FMD in
postmenopausal women significantly approximate normal values [3.8 +
0.3mm (11.4%) P<0.05]. In contrast after estrogen therapy the mean
of absolute brachial artery diameter change for FMD was augmented at
rest (P < 0.01) but was not further enhanced after exercise. [3.7
+1.32 mm (11.5%) VS 3.5+1.4mm (10.5%) P > 0.05]. Both interventions
increased FMD to values in pre menopausal women. Conclusion: in post
menopausal women both acute exercise and oral estrogen normalize FMD.
However there effects weren't additive so these results reinforce
that exercise is an alternative non pharmacological intervention to
estrogen in post menopausal women with endothelial dysfunction.  |
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