'Why isn't the neural tube defects rate lower?,' asks March of Dimes

DALLAS - June 19, 2001 - Researchers at UT Southwestern Medical Center at Dallas report that administering replacement estrogen via a skin patch is superior to oral estrogen replacement therapy in lowering blood pressure and sympathetic nerve activity - the neural control of blood pressure - in postmenopausal women.

The study, published in today's issue of Circulation, is the first to compare the effectiveness of oral and transdermal replacement therapies on sympathetic nerve activity in humans.

These findings suggest that how estrogen is administered is the key in optimizing the beneficial effects of estrogen replacement therapy on blood pressure, said Dr. Wanpen Vongpatanasin, assistant professor of internal medicine in hypertension and lead author of the study.

"Prevalence of hypertension is very low in young pre-menopausal women but increases markedly after menopause, suggesting a protective role of estrogen on blood pressure. Knowledge from this study may lead to an effective therapy to treat or prevent hypertension after menopause," she said.

Vongpatanasin and her colleagues reported that transdermal estrogen, or the estrogen patch, decreased nerve activity in postmenopausal women with normal blood pressure by 30 percent. The researchers also reported a small, but statistically significant, decrease in blood pressure in patients taking transdermal estrogen.

Both nerve activity and blood pressure were unaffected in patients taking oral estrogen. "This is an initial step that leads us to think that all estrogen preparations are not the same," Vongpantanasin said.

"This may be one of the reasons why large clinical trials failed to show a benefit of estrogen replacement therapy on blood pressure or any cardiovascular outcomes. It could very well be because only oral estrogen, the most popular preparation in the United States, has been used rather than transdermal estrogen."

Postmenopausal w

Contact: Michele Kling
March of Dimes Birth Defects Foundation

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