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Raloxifene improves endothelial function in postmenopausal women

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Raloxifene improves endothelial function in postmenopausal women to the same degree as hormone replacement therapy (HRT), Italian researchers report in the September issue of Arteriosclerosis, Thrombosis and Vascular Biology, a journal of the American Heart Association.

Because estrogen has direct effects on the vascular endothelium, the endothelium is thought to have an important role in the cardiovascular protective effects of HRT, they note. "Raloxifene relaxes coronary arteries in vitro…thus suggesting that this selective estrogen receptor modulator could also have beneficial effects on endothelial function."

To investigate, Dr. Francesco Squadrito and colleagues from the University of Messina randomly assigned 90 healthy postmenopausal women to 6 months of raloxifene (60 mg/day), HRT or placebo in a double-blind protocol. At baseline and after 6 months, they measured three markers of endothelial function: endothelium-dependent vasodilation, plasma nitric oxide (NO) concentration and endothelin-1 plasma levels.

Treatment with raloxifene increased the mean level of NO breakdown products from 26.5 µmol/L at baseline to 36.3 µmol/L at 6 months, and the mean plasma endothelin level was reduced from 17.3 pg/mL at baseline to 11.5 pg/mL, the researchers report. Data were similar for women receiving HRT, but these markers of endothelial function did not change among women in the placebo group.

Flow-mediated endothelium-dependent vasodilation of the brachial artery increased from a mean of 8.3% at baseline to 12.3% after 6 months of raloxifene therapy. A similar increase in endothelium-dependent vasodilation was seen among women receiving HRT, but not among those receiving placebo, Dr. Squadrito's group notes.

"Further investigation is warranted to enhance our understanding of the mechanisms of the effect of raloxifene on vascular function and to determine whether its effect on endothelial function may contribute to the reduction in cardiovascular-related morbidity and mortality," the researchers conclude.

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