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

omen have an excessive increase in nerve activity in the sympathetic nervous system. Increased nerve activity in this system causes blood vessels to constrict. An excessive increase may cause hypertension - one of the leading causes of death in women in the United States.

Transdermal estrogen replacement therapy has been shown to decrease nerve activity and blood pressure in female laboratory animals.

"In some female rats, removal of the ovaries leads to an increase in nerve activity and blood pressure. Estrogen replacement in the form of an implant under the skin (the effect of which is similar to transdermal estrogen in humans) reverses this problem," Vongpatanasin said. The 12 study participants randomly received transdermal estrogen replacement therapy for eight weeks, then switched to oral estrogen replacement therapy for eight weeks and a placebo for another eight weeks. The researchers used microelectrodes, which are similar to acupuncture needles, to record sympathetic nerve activity and ambulatory blood pressure readings. The researchers recorded about 50 blood pressure readings during a 24-hour period before and after each eight-week therapy.

In a second portion of the study, the researchers evaluated the effectiveness of intravenous estrogen on blood pressure and sympathetic nerve discharge and found no effect. When given orally, Vongpatanasin said, estrogen is transported to the liver, which converts the most active form of estrogen, called estradiol, into the weakest form of estrogen, called estrone. "In order to have similar blood estradiol levels to those seen with transdermal estrogen, a much higher dose of oral estrogen is needed," she said. "This increases the side effects related to the production of a coagulation protein in the liver, which causes blood clots to form in the legs. Other proteins in the liver may also interfere with the ability of estrogen to reduce blood pressure.

"This s

Contact: Michele Kling
March of Dimes Birth Defects Foundation

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