Control group consisted of 40 postmenopausal women with normal blood pressure.

Patients received hydrochlorothiazide 25 mg/day p.o. for 1 year.

Patients received perindopril 4 mg/day p.o for 1 year.

Patients received hydrochlorothiazide 25 mg/day p.o. and estrogen-progestin therapy- transdermal patches releasing 17β-estradiol (0.05 mg/24 hours) and norethisterone (0.25 mg/24 hours) for 1 year

Patients received perindopril 4 mg/day p.o and estrogen-progestin therapy- transdermal patches releasing 17β-estradiol (0.05 mg/24 hours) and norethisterone (0.25 mg/24 hours) for 1 year

Patients received estrogen-progestin therapy- transdermal patches releasing 17β-estradiol (0.05 mg/24 hours) and norethisterone (0.25 mg/24 hours) for 1 year.

Hypertension

Hyperuricemia

Menopause

Perindopril

hydrochlorothiazide 25 mg/day p.o. for 12 months

Hydrochlorothiazide

Transdermal patches releasing 17β-estradiol (0.05 mg/24 hours) and norethisterone (0.25 mg/24 hours) for 12 months

Estracomb TTS

Reversal of an Unfavorable Effect of Hydrochlorothiazide Compared to Angiotensin Converting Enzyme Inhibitor on Serum Uric Acid and Oxypurines Levels by Estrogen-progestin Therapy in Hypertensive Postmenopausal Women.

As compared with normotensive women, hypertensive women showed higher office and ambulatory blood pressure, as well as a lower night-time decrease in systolic and diastolic blood pressure.
Both perindopril and hydrochlorothiazide led to a similar reduction in arterial blood pressure in hypertensive women.
After 12 months of treatment, statistically significant differences were observed between the EPT+ and EPT- subgroups in systolic and diastolic office-based blood pressure in the study group treated with ACEI. Such effect of EPT on ABPM(ambulatory blood pressure monitoring) was not observed in all study participants. Multiple linear regression models have shown that after 12 months of antihypertensive treatment there were no significant differences in night-time decrease in blood pressure caused by EPT treatment, despite its significant change when compared to baseline values for ACEI and HCTZ subgroups.

As compared with normotensive women, hypertensive women showed lower GFR and RPF.
Glomerular filtration rate (GFR) remained unaltered in all subgroups throughout the duration of the study. When compared to the baseline values, renal plasma flow (RPF) increased significantly in women treated with perindopril, both with and without EPT. At the end of the study, there were no differences in RPF in the two subgroups of ACEI (EPT+ vs EPT-) groups. RPF also increased in women treated with hydrochlorothiazide and receiving EPT. However, RPF was substantially reduced in the subgroup of women treated with hydrochlorothiazide without EPT.

Hypertensive women had significantly higher serum uric acid levels than normotensive women, whereas clearance and fractional excretion of uric acid were significantly lower in hypertensive than in normotensive women.
Uric acid levels in plasma decreased significantly in women treated with perindopril, both in the subgroup receiving and not receiving hormone replacement therapy (HRT).
At the end of the study, there were no significant differences in plasma uric acid levels in two subgroups treated with ACEI (EPT+ vs EPT-) In hypertensive women treated with hydrochlorothiazide, uric acid concentrations in plasma decreased significantly when compared to the baseline values, but only in the subgroup receiving estrogen-progestin therapy.

In the groups of hypertensive women, serum xanthine and hypoxanthine levels were significantly higher than in the group of normotensive women.
In multivariate analysis, behavior of xanthine and hypoxanthine in the subgroups treated with or without EPT showed significant differences in patients treated with diuretic. In women treated with ACEI with or without EPT, only hypoxanthine levels decreased significantly

Anna Posadzy-Małaczyńska

Habilitated doctor of Medical Sciences in Medicine

Postmenopausal women with, untreated essential hypertension were recruited to the study. The control group consisted of 40 postmenopausal women with normal blood pressure.

uricase/cough

Reversal of an Unfavorable Effect of Hydrochlorothiazide Compared to Angiotensin Converting Enzyme Inhibitor on Serum Uric Acid and Oxypurines Levels by Estrogen-progestin Therapy in Hypertensive Postmenopausal Women.

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