Estrogen Has Anti-Ischemic Effect in Men, Too
By Bruce Jancin
Family Practice News
--Contributed by Trish
MINNEAPOLIS
High-dose estrogen has an acute beneficial effect upon
myocardial ischemia in men with coronary disease.
Thus, the cardiovascular benefits of estrogen are not gender
specific, Dr. Susan R. Davis declared at the annual meeting of the
Endocrine Society.
She reported on 12 men with established coronary disease and
consistently abnormal exercise treadmill tests who received 25 mg of IV
Premarin on one occasion 2 hours prior to stress testing and a matching
volume of saline prior to another treadmill test. All antianginal drugs
were stopped 48 hours beforehand in this randomized, double-blind study.
Pretreatment with Premarin resulted in a significant increase in
total exercise time and in exercise duration required to elicit a 1-mm
ST-segment depression.
Given the likelihood of a carryover effect from the patients'
recently halted beta blockers and calcium channel blockers, this study
probably underestimates the true acute benefit.
Further study of estrogen and agents with estrogenlike effects upon
coronary artery vasomotor function is warranted in men, concluded Dr.
Davis, of the Jean Hailes' Foundation in Clayton, Australia.
Also under study is the use of insulin-like growth factor-1 (IGF-1
in patients with congestive heart failure.
Dr. Marc Y. Donath reported that acute administration of IGF-1 in
eight congestive heart failure patients improved cardiac function by
afterload reduction and possibly through a positive inotropic effect.
In this randomized, double-blind crossover trial, IGF-1 was
associated with a 27% rise in cardiac indes, a 21% boost in stroke
volume index, a 28% reduction in systemic vascular resistance, a 25%
decline in pulmonary artery wedge pressure, and a 33% drop in right
atrial pressure, compared with placebo during 7 hours of continuous
monitoring, said Dr. Donath, of University Hospital, Zurich,"
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