6 VASCULAR EFFECTS OF CALCIUM-HORMONAL THERAPY IN THE GENERAL POPULATION

Calcium and hormonal replacement therapy (Cal-HRRx) increased adrenergic neurovascular tone (ANVT), systemic vascular resistance (SVR) and NV symptom levels (SL) in 50% of our pilot study (PS). In prospective studies (ProS) serial measurements (SM) were made of: systolic time intervals (STI), SBP, rise in pulse pressure to handgrip (RPPHg, 5 PSI, 3 min), systemic vascular resistance (SVR), and cardiac output (CO) by echo. NVT SL (i.e.: migraine, paresthesias, chest wall SL, etc.) were assessed by the quality of life (QL, 0-100%). STI monitored ANVT (STI=PEP/LVET X 100%). The parameters were studied by: SVR = (mean BP-6) X 80/CO, using standard units. In ProS women with type A/AX/B behavior were randomized from the general population (GenP) into 100/ group (G) with normal CO (4 -7 L/min). A subgroup of type A (SA) with low BP (≤100 mmHg) and CO (≤4) were studied as a G. All women were: postmenopausal, age 55±5, with STI levels at low stress PS G means ± 2, and SBP 110±10 mmHg. Type B women were age-matched controls on the Rx protocol. Daily Cal-HRRx was: 1500 mg Cal, 0.625 estrogen and 2.5 mg progesterone in each G on a double blind placebo cross-over protocol (3mo. each). Data was collected at time 1 (T1=low stress on dietary Cal at 500 mg/day and placebo) and T2 on Cal-HRRx, both at 2 week intervals for 12 weeks. Standard ultrasonic measurements (UM) were made at T1 and T2 (end). Data was placed into a blind matrix for analysis later. ProS G analysis: G means shown. (Table) Where: * = Significant (Sig) difference from GB at P≤0.01 and ** = Sig change from T1 at P≤0.02, both by T test. % = % of total # cases. %NC = %Non-compliance (left study due to high SL). Sig** coronary risk occurred in GA (38% of GenP) due to SBP and ANVT (proven in parallel long-term studies by serial UM, R=0.97, P≤0.001) with Sig** increase in SL during Rx. A RPPHg ≥15 before Rx predicted type A women at risk (R=0.98, P≤0.001). The SA G had decreased SBP but increased coronary risk due to Sig** ANVT increase (STI change) on Rx (proven in long-term parallel studies, R=0.97, P≤0.001). Thus, Cal-HRRx is found to cause Sig vascular risk in 50% of the GenP due to increases in ANVT in type A women.