Fung and colleagues have recently reported on a cross-sectional study, followed by a prospective analysis, on the effect of continuous postmenopausal estrogen therapy over a period of 10 years on blood pressure, microalbuminuria and renal function . A total of 1044 postmenopausal women (mean age 72 years) were evaluated cross-sectionally between 1992 and 1996. These women formed the baseline of the study and 443 women from this population were re-evaluated 10 years later (2002–2005). The associations of estrogen therapy with blood pressure, urine albumin/creatinine ratio, glomerular filtration rate, chronic kidney disease and albuminuria were determined in this study. In the cross-sectional analyses, current users (for an average duration of 16.5 years) had lower diastolic blood pressure and lower odds of having hypertension and chronic kidney disease, independent of covariates. Current users also had the lowest body mass index and serum creatinine levels when compared to past or never-users. Both diabetes and chronic kidney disease were more common in never-users. A total of 443 participants (60% of survivors) returned for the follow-up visit some 10 years later (87 never-users, 247 past users and 109 current users). After age adjustment, statistically significant differences between the three groups were found only for the albumin/creatinine ratio. Differences in body mass index, systolic or diastolic blood pressure, and glomerular filtration rate did not reach statistical significance although estrogen therapy seemed beneficial. Mean diastolic blood pressure declined over time in current users, whereas systolic blood pressure increased among never-users.
Chairman, Indian College of Obstetricians & Gynecologists, Mumbai, India