Aerobic training abolishes ambulatory blood pressure increase induced by estrogen therapy: A double blind randomized clinical trial

Emerging data reveal that oral estrogen therapy can increase clinic blood pressure (BP) in post-menopausal women; however, it is important to establish its effects on ambulatory BP, which is a better predictor for target-organ damage. Besides estrogen therapy, aerobic training is widely recommended for post-menopausal women, and it can decrease ambulatory BP levels. This study was designed to evaluate the effect of aerobic training and estrogen therapy on the ambulatory BP of post-menopausal women. Forty seven healthy hysterectomized women were randomly divided (in a double-blind manner) into 4 groups: placebo–control (PLA–CO = 12), estrogen therapy–control (ET–CO = 14), placebo–aerobic training (PLA–AT = 12), and estrogen therapy–aerobic training (ET–AT = 09). The ET groups received estradiol valerate (1 mg/day) and the AT groups performed cycle ergometer, 3×/week at moderate intensity. Hormonal status (blood analysis), maximal cardiopulmonary exercise test (VO2 peak) and ambulatory BP (24-h, daytime and nighttime) was evaluated before and 6 months after interventions. A significant increase in VO2 peak was observed only in women who participated in aerobic training groups (+4.6 ± 1.0 ml kg−1 min−1, P = 0.00). Follicle-stimulating hormone was a significant decreased in the ET groups (−18.65 ± 5.19 pg/ml, P = 0.00), and it was accompanied by an increase in circulating estrogen (56.1 ± 6.6 pg/ml). A significant increase was observed in the ET groups for daytime (P = 0.01) and nighttime systolic BP (P = 0.01), as well as nighttime diastolic BP (P = 0.02). However, daytime diastolic BP was increased only in the ET–CO group (+3.4 ± 1.2 mmHg, P = 0.04), and did not change in any other groups. No significant effect was found in ambulatory heart rate. In conclusion, aerobic training abolished the increase of daytime ambulatory BP induced by estrogen therapy in hysterectomized, healthy, normotensive and postmenopausal women.