Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-03-24Bitstream added on 2014-06-13T20:36:53Z : No. of bitstreams: 1 giro_g_me_arafo.pdf: 376478 bytes, checksum: 41b9f6bee6825f87f572627898751b2f (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / O presente estudo teve como objetivo avaliar a influência da deficiência de estrógeno promovida pela ovariectomia (OVX) sobre o tecido ósseo ao redor de implantes com osseointegração estabelecida. Foram utilizadas ratas Wistar, com idade aproximada de 60 dias e peso variando entre 180g a 220g, submetidas à colocação de um implante na metáfise tibial. Os tratamentos utilizados foram eficientes na prevenção da perda óssea. Os animais que receberam a administração do alendronato apresentaram os melhores resultados para todas as análises realizadas. A deficiência de estrógeno decorrente da OVX acarretou prejuízos para a BMD, densidade radiográfica da região de osso medular e torque de remoção dos implantes. Esse quadro pôde ser revertido com a utilização dos tratamentos instituídos, com o alendronato apresentando os melhores resultados. / The aim of the present study was to evaluate the influence of estrogen deficiency due to ovariectomy (OVX) on the bone around osseointegrated titanium implants. Wistar female rats - approximately 60 days old, weighting from 180 to 220 g - were used. Digital radiographs were taken and the implants were submitted to the removal toque. The results showed a negative effect of the OVX on the BMD at the femur and lumbar regions, on the radiographic bone density at the cancellous bone and on the biomechanical characteristics of the bone tissue around the implants. The treatments were efficient preventing bone loss. The animals that received alendronate therapy showed the best results for all the analyzed variables. we can conclude that the estrogen deficiency due to OVX had a negative influence on the BMD, on the radiographic bone density at the cancellous bone and on the removal torque of the implants; however, such negative influence can be reversed with the adopted therapies, among which the alendronate seemed to be the best method for prevention and treatment of bone loss due to OVX.

Abstract Estrogen replacement therapy (ERT) has been associated with favorable effects on risk factors for atherosclerosis. In observational studies ERT was also suggested to reduce the risk of cardiovascular disease in postmenopausal women, but the cardioprotective role of estrogen has been challenged after negative results in randomized trials. However, the mechanisms of estrogen action in atherosclerosis development are only partially known. In order to investigate the regulation of plasma low-density lipoprotein (LDL) cholesterol in postmenopausal women and the effects of ERT on cholesterol and glucose metabolism and blood pressure, 79 hysterectomized, non-diabetic postmenopausal women were randomized in a double-blind, double-dummy study to receive either peroral estradiol valerate (2 mg/day) or transdermal 17β-estradiol gel (1 mg estradiol/day) for six months. At baseline the level of LDL cholesterol was related to body mass index, the fractional catabolic rate (FCR) and the production of LDL apolipoprotein B (apo B), but not to cholesterol absorption efficiency. Both peroral and transdermal ERT decreased plasma total and LDL cholesterol, while high-density lipoprotein cholesterol and triglycerides increased only in the peroral group. The LDL-lowering response was related to changes in estrogen levels, which presumably enhance LDL receptor activity shown as an increase in FCR for LDL apo B. In contrast, the determined genetic factors, apo E phenotype, EcoRI and XbaI polymorphisms of the apo B gene and polymorphism of 7α-hydroxylase gene, were not significant in regulation of LDL cholesterol, neither did they modify the response of ERT in these postmenopausal women. Similar outcomes were observed with both peroral and transdermal ERT as regards glucose metabolism and blood pressure. The overall effect of ERT on glucose tolerance was found to be neutral. Blood pressure decreased among non-hypertensive subjects on both estrogens, which could be related, at least in part, to the alterations in vasoactive peptides. The data of the present study suggest an overall favorable effect of both peroral and transdermal estrogen on common cardiovascular risk factors. However, the clinical significance of these findings in the prevention of cardiovascular diseases needs to be proven in long-term, randomized trials.

No description available.

Conclusion 1. The results of the research partly supported hypothesis 1a. There was a significant reduction in both endothelium-dependent arterial relaxation following a surgical menopause. The results of the research partly supported hypothesis 1b. There was a significant reduction in endothelium-dependent arterial relaxation but no significant effect on endothelium-independent arterial relaxation. / Conclusion 2. The results of the research partly supported hypothesis 2a. The addition of unopposed oestrogen significantly improved endothelium-dependent but not endothelium-independent arterial relaxation. The results of the research supported hypothesis 2b. The addition of oestradiol combined with progestogen (norethisterone acetate) reversed the reduction in arterial relaxation caused by a surgical menopause. The results of the research partly supported hypothesis 2c. The addition of tibolone reversed the reduction endothelium-dependent but not endothelium-independent arterial relaxation. The results of the research partly supported hypothesis 2d. The addition of oestradiol combined with a progestogen (norethisterone acetate) reversed the reduction in endothelium-dependent but not endothelium-independent arterial relaxation. / Conclusion 3. The results of the research partly supported hypothesis 3a. Endothelium-dependent arterial relaxation but no endothelium-independent arterial relaxation was improved after the addition of menopausal hormone therapy using oestrogen combined with a progestogen in a continuous manner. The results of the research did not support hypothesis 3b. Neither endothelium-dependent arterial relaxation nor the endothelium-independent arterial relaxation was improved by cyclical menopausal HT. / Conclusion 4. The results of the research did not support hypothesis 4. The addition of menopausal hormone therapy using combined oestrogen with progestogen did not improve arterial relaxation in postmenopausal women with established coronary heart disease. / Hypothesis 2. This hypothesis examined three different types of commonly used menopausal HT. That unopposed oestrogen (2a), oestrogen combined with a progestogen (2b and 2d) or a synthetic steriod that has oestrogenic, progestogenic as well as androgenic activity (tibolone, 2c), reverse the reduction in arterial relaxation following menopause in Hong Kong Chinese women. / Hypothesis 3. That menopausal hormone therapy using oestrogen combined with progestogen given in either continuous (3a) or cyclical (3b) regimens improves arterial relaxation in postmenopausal Hong Kong Chinese women. / Hypothesis 4. That menopausal hormone therapy using combined oestrogen with progestogen improves arterial relaxation in postmenopausal Hong Kong Chinese women with established coronary heart disease. / Menopausal HT can in general at least partially reverse changes in arterial relaxation in postmenopausal women. Different types of menopausal HT exhibit different effects on arterial relaxation. In healthy vessels, menopause HT mainly reverses the endothelium-dependent vascular effect, but it remains unclear how menopausal HT affects the endothelium-independent vascular effect. However, with established coronary heart disease, menopausal HT cannot reverse the changes in vascular reactivity. / Summary. Menopause results in a reduction in arterial relaxation. However, GnRHa temporarily induced menopause in young women, the endothelium-independent vasodilatation was not impaired. This difference can be partly explained by the difference in age as vascular reactivity is age dependent. Secondly, GnRHa works with an initial phase of increase in oestrogen production resulting in a shorter duration of hypo-oestrogenism resulting in the lack of impairment on endothelium-independent vasodilatation. / This thesis tested the following hypotheses: Hypothesis 1. That vascular reactivity decreases after the menopause as shown in premenopausal Hong Kong Chinese women with either a surgical (1a) or a medically induced (1b) menopause. / This thesis will examine the effects of menopause and menopausal HT on arterial reactivity which is an indirect measurement of vascular function. Previous studies have shown that oestrogen is a potent coronary artery vasodilator, and this effect may be mediated via both endothelium-dependent and endothelium-independent mechanisms. One method of assessing vascular reactivity is to use ultrasound measurement of changes in brachial artery diameter in response to certain stimuli. Using this technique, changes in both endothelium-dependent and endothelium-independent vasodilatation can be measured. Increased rather than decreased arterial relaxation after stimulus can be viewed as a favourable response. / Yim, So-fan. / Adviser: C. J. Haines. / Source: Dissertation Abstracts International, Volume: 68-09, Section: B, page: 5873. / Thesis (M.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 159-194). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Resumo: O presente estudo teve como objetivo avaliar a influência da deficiência de estrógeno promovida pela ovariectomia (OVX) sobre o tecido ósseo ao redor de implantes com osseointegração estabelecida. Foram utilizadas ratas Wistar, com idade aproximada de 60 dias e peso variando entre 180g a 220g, submetidas à colocação de um implante na metáfise tibial. Os tratamentos utilizados foram eficientes na prevenção da perda óssea. Os animais que receberam a administração do alendronato apresentaram os melhores resultados para todas as análises realizadas. A deficiência de estrógeno decorrente da OVX acarretou prejuízos para a BMD, densidade radiográfica da região de osso medular e torque de remoção dos implantes. Esse quadro pôde ser revertido com a utilização dos tratamentos instituídos, com o alendronato apresentando os melhores resultados. / Abstract: The aim of the present study was to evaluate the influence of estrogen deficiency due to ovariectomy (OVX) on the bone around osseointegrated titanium implants. Wistar female rats - approximately 60 days old, weighting from 180 to 220 g - were used. Digital radiographs were taken and the implants were submitted to the removal toque. The results showed a negative effect of the OVX on the BMD at the femur and lumbar regions, on the radiographic bone density at the cancellous bone and on the biomechanical characteristics of the bone tissue around the implants. The treatments were efficient preventing bone loss. The animals that received alendronate therapy showed the best results for all the analyzed variables. we can conclude that the estrogen deficiency due to OVX had a negative influence on the BMD, on the radiographic bone density at the cancellous bone and on the removal torque of the implants; however, such negative influence can be reversed with the adopted therapies, among which the alendronate seemed to be the best method for prevention and treatment of bone loss due to OVX. / Orientador: Silvana Regina Perez Orrico / Coorientador: Elcio Marcantonio Junior / Banca: Luiz Antonio Pugliesi Alves de Lima / Banca: Roberto Henrique Barbeiro / Mestre

Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2006. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-11-19T17:15:08Z No. of bitstreams: 1 rosaurapinto.pdf: 928121 bytes, checksum: 7c54a392f96fa8daa07d4f0d24204fa9 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2012-11-30T15:10:19Z (GMT) No. of bitstreams: 1 rosaurapinto.pdf: 928121 bytes, checksum: 7c54a392f96fa8daa07d4f0d24204fa9 (MD5) / Made available in DSpace on 2012-11-30T15:10:19Z (GMT). No. of bitstreams: 1 rosaurapinto.pdf: 928121 bytes, checksum: 7c54a392f96fa8daa07d4f0d24204fa9 (MD5) Previous issue date: 2006 / O objetivo desta pesquisa foi avaliar a influência da terapia hormonal (TH) na qualidade de vida das mulheres no climatério. Realizou-se um estudo de corte transversal com mulheres entre 40 e 65 anos atendidas no Ambulatório de Climatério do Hospital Universitário da Fundação Universidade Federal do Rio Grande (HU-FURG) e em clínica privada, nos meses de junho, julho e agosto de 2005. Foram consideradas como usuárias aquelas que usavam TH há pelo menos 6 meses no momento da coleta de dados. Foram excluídas usuárias de anticoncepcional hormonal e usuárias de qualquer tipo de medicação, não hormonal, para alívio dos sintomas climatéricos nos últimos 6 meses. Participaram do estudo 229 mulheres, 61 usuárias de TH e 168 não usuárias. Avaliaram-se características sócio demográficas e biológicas. O instrumento utilizado para a avaliação da qualidade de vida no climatério foi o Questionário de Saúde da Mulher (QSM). A análise dos dados foi realizada através dos testes do Qui-quadrado (exato de Fisher), teste “t” de student, teste de tendência linear, teste de análise de variância fatorial 2 x 2 e teste post-hoc de Tukey. A idade média (49,2 ± 5,2 anos) e idade média da menopausa (44,5 ± 5,2 anos) das usuárias de TH foram menores do que as das não usuárias (50,9 ± 6,8 anos e 47,11± 4,8 anos respectivamente) (p=0,04 e p=0,02). Ocorreu aumento do uso de TH com o aumento da renda (p<0,05). Não ocorreu interação entre renda e TH, quando se procurou identificar se as maiores rendas e não a TH melhoravam a qualidade de vida. Dos 9 domínios de qualidade de vida avaliados pelo QSM, em 6 os escores foram melhores para as usuárias de TH (sintomas vasomotores, ansiedade e temores, memória e concentração,comportamento sexual, sintomas somáticos e sintomas depressivos). Independente do uso ou não de TH as mulheres com renda familiar maior do que 5 salários apresentaram melhores escores para qualidade de vida nos domínios sintomas vasomotores (p<0,05), ansiedade e temores (p<0,01), memória e concentração (p<0,05), comportamento sexual (p<0,05), sintomas depressivos (p<0,01) e problemas do sono (p<0,05) do que as mulheres com menor renda familiar. Os sintomas vasomotores foram os referidos como sendo os mais difíceis de conviver (p<0,01). A usuárias de TH apresentaram melhor qualidade de vida. / This research aims at assessing the influence of hormonal therapy (HT) on climacteric women’s quality of life. A cross-sectional study was carried out with women between 40 and 65 years old who sought for assistance at the Ambulatório de Climatério, a health center that focus on climacterics, in the university hospital that belongs to the Fundação Universidade do Rio Grande (HU-FURG), and at a private office, in June, July, and August 2005. Women who had already used HT for at least 6 months when the data was collected were considered users of the therapy. Women who had used hormonal birth control or any kind of non-hormonal treatment to relieve climacteric symptoms in the previous 6 months were excluded. The study was carried out with 229 women; 61 were users of HT, whereas 168 were non-users. Sociodemographic and biological features were assessed. The instrument chosen to assess climacteric women’s quality of life was the Women’s Health Questionnaire (WHQ). Data analysis used Chi-square tests (Fisher), student’s “t” test, linear tendency test, analysis of factorial variance 2x2, and Tukey’s post-hoc test. The average age of the users of HT (49.2 ± 5.2 years old) and the average age in which their menopause started (44.5 ± 5.2 years old) are under those of the non-users (50.9 ± 6.8 and 47.11 ± 4.8 years old, respectively)(p = 0.04 and p = 0.02). Higher income (p < 0,05) increased use of HT. No interaction was found between income and HT when I tried to identify if higher income, rather than HT, had improved their quality of life. Taking into consideration the nine dimensions of quality of life assessed by the WHQ, six of them presented better scores for users of HT (vasomotor symptoms, anxiety and fears, memory and concentration, sexual behavior, somatic symptoms, and depressive symptoms). Regardless of the use of HT, women with a family income above five minimum salaries (when compared to women with lower family income) presented better scores for quality of life in the following dimensions: vasomotor symptoms (p < 0.05), anxiety and fears (p < 0.01), memory and concentration (p < 0.05), sexual behavior (p < 0.05), depressive symptoms (p < 0.01), and sleep problems (p < 0.05). The vasomotor symptoms were considered the hardest to live with (p < 0.01). HT users had better quality of life. / El objetivo de esta pesquisa fue evaluar la influencia de la terapia hormonal (TH) en la calidad de vida de las mujeres en el climaterio. Se realizó un estudio de corte transversal con mujeres entre 40 y 65 años atendidas en el Ambulatorio de Climaterio del Hospital Universitario de la Fundação Universidade Federal do Rio Grande (HU-FURG) y en clínica privada, en los meses de junio, julio y agosto de 2005. Fueron consideradas como usuarias aquellas que utilizaban TH hace 6 meses en el momento de la colecta de datos. Fueron excluidas usuarias de anticonceptivo hormonal y usuarias de cualquier tipo de medicación, no hormonal, para el alivio de los síntomas climatéricos en los últimos 6 meses. Participaron del estudio 229 mujeres, 61 usuarias de TH y 168 no usuarias. Fueron evaluadas características sócio demográficas y biológicas. El instrumento utilizado para la evaluación de la calidad de vida en el climaterio fue el Cuestionario de Salud de la Mujer (QSM). El análisis de los datos fue realizado a través de los testes del Qui-quadrado (exacto de Fisher), test “t” de student, test de tendencia linear, test de análisis de la variancia factorial 2 x 2 y el test post-hoc de Tukey. La edad media (49,2 ± 5,2 años) y la edad media de la menopausia (44,5 ± 5,2 años) de las usuarias de TH fueron menores de lo que de las no usuarias (50,9 ± 6,8 anos e 47,11± 4,8 años respectivamente)(p=0,04 y p=0,02). Ocurrió aumento del uso de TH con el aumento de la renta (p<0,05). No ocurrió interacción entre la renta y TH, cuando se buscó identificar si las mayores rentas y no la TH mejoraban la calidad de vida. De los 9 dominios de calidad de vida evaluados por QSM, en 6 los escores fueron mejores para las usuarias de TH (síntomas vasomotores, ansiedad y temores, memoria y concentración, comportamiento sexual, síntomas somáticos y síntomas depresivos). Independiente del uso o no de TH las mujeres con renta familiar mayor de 5 salarios presentaron mejores escores para calidad de vida en los dominios síntomas vasomotores (p<0,05), ansiedad y temores (p<0,01), memoria y concentración (p<0,05), comportamiento sexual (p<0,05), síntomas depresivos (p<0,01) y problemas del sueño (p<0,05) de lo que las mujeres con menor renta familiar. Los síntomas vasomotores fueron los referidos como siendo los más difíciles de convivir (p<0,01). Las usuarias de TH presentaron mejor calidad de vida.

A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (FSA - pletismografia) em um período basal e durante exercícios estático e dinâmico com handgrip a 30% da força de contração máxima. Para análise estatística foi utilizada ANOVA. O TF isoladamente diminuiu ANSP de 40±7 a 34±4 impulsos/min, (P=0,01) e aumentou FSA de 1,92±0,96 a 2,65±1,34 ml(min.100ml), P=0,03 no período basal. TRH e TF associados reduziram a FC no período basal de 65±8 para 62±7 bpm (P=0,01) e durante o exercício estático e dinâmico com handgrip. A TRH de maneira isolada ou associada ao TF diminuiu as respostas de FC durante os exercícios estático e dinâmico com handgrip. Em conclusão, as intervenções de maneira isolada ou associada promovem alterações hemodinâmicas e neurais que podem contribuir para redução do risco cardiovascular de mulheres pós-menopausadas saudáveis. / The post-menopause is marked by physiological hemodynamic and metabolic changes. The estrogen replacement therapy is a way to reduce the consequences of hormone deficiency and physical exercise contributes significantly to the reduction of cardiovascular risk. The aim of this study was to evaluate in post-menopausal women the isolated and associated effects of oral estrogen therapy (TRH) and physical training (TF) in the neural and hemodynamic responses during baseline and \"handgrip\" exercises. Forty-five women (51 ± 3 years), hysterectomized, with or without ovaries, healthy, participated of an initial session and then they were divided into 4 groups SEDPLA (n = 11), SED-TRH (n = 14), TF-PLA (n = 12) and TF-TRH (n = 8). The TRH groups received estradiol valerate 1 mg / day; PLA placebo; TF, performed aerobic exercise on a cycle ergometer for 50 minutes, 3 times a week and SED remained sedentary. All subjects participated in a second experimental session after 6 months of follow-up. In the experimental sessions peripheral sympathetic nerve activity (ANSP - microneurography), blood pressure, heart rate (FC - oscillometry - Dixtal lower limb), forearm blood flow (FSA - plethysmography) were evaluated at the baseline period and during static and dynamic \"handgrip\" exercises at 30% of the maximum force. ANOVA was used for the statistica analysis. The TF alone decreased ANSP from 40 ± 7 to 34 ± 4 bursts/min, P = 0.01 and increased FSA 1.92 ± 0.96 to 2.65 ± 1.34 ml (min.100ml), P = 0.03 at the baseline. The association of TRH and TF reduced HR at the baseline from 65 ± 8 to 62 ± 7 bpm (P=0.01) and during exercise with static and dynamic \"handgrip\". HRT alone or associated with TF decreased the HR responses during static and dynamic \"handgrip exercises. In conclusion, the interventions alone or in an associated way promote neural and hemodynamic changes that may contribute to cardiovascular risk reduction in healthy postmenopausal women.

A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (FSA - pletismografia) em um período basal e durante exercícios estático e dinâmico com handgrip a 30% da força de contração máxima. Para análise estatística foi utilizada ANOVA. O TF isoladamente diminuiu ANSP de 40±7 a 34±4 impulsos/min, (P=0,01) e aumentou FSA de 1,92±0,96 a 2,65±1,34 ml(min.100ml), P=0,03 no período basal. TRH e TF associados reduziram a FC no período basal de 65±8 para 62±7 bpm (P=0,01) e durante o exercício estático e dinâmico com handgrip. A TRH de maneira isolada ou associada ao TF diminuiu as respostas de FC durante os exercícios estático e dinâmico com handgrip. Em conclusão, as intervenções de maneira isolada ou associada promovem alterações hemodinâmicas e neurais que podem contribuir para redução do risco cardiovascular de mulheres pós-menopausadas saudáveis. / The post-menopause is marked by physiological hemodynamic and metabolic changes. The estrogen replacement therapy is a way to reduce the consequences of hormone deficiency and physical exercise contributes significantly to the reduction of cardiovascular risk. The aim of this study was to evaluate in post-menopausal women the isolated and associated effects of oral estrogen therapy (TRH) and physical training (TF) in the neural and hemodynamic responses during baseline and \"handgrip\" exercises. Forty-five women (51 ± 3 years), hysterectomized, with or without ovaries, healthy, participated of an initial session and then they were divided into 4 groups SEDPLA (n = 11), SED-TRH (n = 14), TF-PLA (n = 12) and TF-TRH (n = 8). The TRH groups received estradiol valerate 1 mg / day; PLA placebo; TF, performed aerobic exercise on a cycle ergometer for 50 minutes, 3 times a week and SED remained sedentary. All subjects participated in a second experimental session after 6 months of follow-up. In the experimental sessions peripheral sympathetic nerve activity (ANSP - microneurography), blood pressure, heart rate (FC - oscillometry - Dixtal lower limb), forearm blood flow (FSA - plethysmography) were evaluated at the baseline period and during static and dynamic \"handgrip\" exercises at 30% of the maximum force. ANOVA was used for the statistica analysis. The TF alone decreased ANSP from 40 ± 7 to 34 ± 4 bursts/min, P = 0.01 and increased FSA 1.92 ± 0.96 to 2.65 ± 1.34 ml (min.100ml), P = 0.03 at the baseline. The association of TRH and TF reduced HR at the baseline from 65 ± 8 to 62 ± 7 bpm (P=0.01) and during exercise with static and dynamic \"handgrip\". HRT alone or associated with TF decreased the HR responses during static and dynamic \"handgrip exercises. In conclusion, the interventions alone or in an associated way promote neural and hemodynamic changes that may contribute to cardiovascular risk reduction in healthy postmenopausal women.

Thesis (Ph. D.)--University of Washington, 2003. / Includes bibliographical references (leaves 101-113).

A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (FSA - pletismografia) em um período basal e durante exercícios estático e dinâmico com handgrip a 30% da força de contração máxima. Para análise estatística foi utilizada ANOVA. O TF isoladamente diminuiu ANSP de 40±7 a 34±4 impulsos/min, (P=0,01) e aumentou FSA de 1,92±0,96 a 2,65±1,34 ml(min.100ml), P=0,03 no período basal. TRH e TF associados reduziram a FC no período basal de 65±8 para 62±7 bpm (P=0,01) e durante o exercício estático e dinâmico com handgrip. A TRH de maneira isolada ou associada ao TF diminuiu as respostas de FC durante os exercícios estático e dinâmico com handgrip. Em conclusão, as intervenções de maneira isolada ou associada promovem alterações hemodinâmicas e neurais que podem contribuir para redução do risco cardiovascular de mulheres pós-menopausadas saudáveis. / The post-menopause is marked by physiological hemodynamic and metabolic changes. The estrogen replacement therapy is a way to reduce the consequences of hormone deficiency and physical exercise contributes significantly to the reduction of cardiovascular risk. The aim of this study was to evaluate in post-menopausal women the isolated and associated effects of oral estrogen therapy (TRH) and physical training (TF) in the neural and hemodynamic responses during baseline and \"handgrip\" exercises. Forty-five women (51 ± 3 years), hysterectomized, with or without ovaries, healthy, participated of an initial session and then they were divided into 4 groups SEDPLA (n = 11), SED-TRH (n = 14), TF-PLA (n = 12) and TF-TRH (n = 8). The TRH groups received estradiol valerate 1 mg / day; PLA placebo; TF, performed aerobic exercise on a cycle ergometer for 50 minutes, 3 times a week and SED remained sedentary. All subjects participated in a second experimental session after 6 months of follow-up. In the experimental sessions peripheral sympathetic nerve activity (ANSP - microneurography), blood pressure, heart rate (FC - oscillometry - Dixtal lower limb), forearm blood flow (FSA - plethysmography) were evaluated at the baseline period and during static and dynamic \"handgrip\" exercises at 30% of the maximum force. ANOVA was used for the statistica analysis. The TF alone decreased ANSP from 40 ± 7 to 34 ± 4 bursts/min, P = 0.01 and increased FSA 1.92 ± 0.96 to 2.65 ± 1.34 ml (min.100ml), P = 0.03 at the baseline. The association of TRH and TF reduced HR at the baseline from 65 ± 8 to 62 ± 7 bpm (P=0.01) and during exercise with static and dynamic \"handgrip\". HRT alone or associated with TF decreased the HR responses during static and dynamic \"handgrip exercises. In conclusion, the interventions alone or in an associated way promote neural and hemodynamic changes that may contribute to cardiovascular risk reduction in healthy postmenopausal women.