Background and Objective: Arterial stiffness and aortic hemodynamics are important determinants of cardiovascular disease risk. Menopausal hormone therapy (MHT) reduces progression of cardiovascular disease in postmenopausal women due to its effects on the endothelium and smooth muscle of the central and peripheral vasculature. However, it remains unclear whether these effects are sustained after MHT cessation. We hypothesized that MHT administered early during the menopausal transition (less than three years from menopause) would not produce a sustained protective effect on aortic hemodynamics in women following discontinuation of MHT.

Methods: We studied fifty-seven women, as part of the Mayo Clinic Specialized Center of Research on Sex Differences, who were randomized into either oral conjugated equine estrogen (oCEE, n=15), transdermal 17β estradiol (tE2, n=20), or placebo (n=22) for four years. After a three year washout period, aortic hemodynamics were measured using radial arterial applanation tonometry.

Results: Age, body mass index and mean arterial pressure were similar among the women. Augmentation index (AIx) was similar among groups (32.6±2.3%, 33.9±1.9%, 31.5±1.9%; oCEE vs. tE2 vs. placebo, respectively, p>0.05) and did not change when normalized for heart rate at 75 bpm (27.6±2.3%, 28.2±1.6%, 25.7±1.8%; oCEE vs. tE2 vs. placebo, respectively, p>0.05). There were no differences in augmented pressure (12.6±1.6, 13.6±1.2, 12.0±0.9 mmHg; oCEE vs. tE2 vs. placebo, respectively, p>0.05) or left ventricular wasted energy (2843±170, 3208±360, 2559±205 dyne·cm²·sec; oCEE vs. tE2 vs. placebo, respectively, p>0.05) among the three groups.

Conclusion: These data suggest that any changes in aortic hemodynamics during MHT use are not sustained following MHT discontinuation.