Wan Din. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 155-175). / ABSTRACT --- p.1 / ACKNOWLEDGMENTS --- p.3 / LIST OF TABLES --- p.5 / LIST OF FIGURES --- p.7 / LIST OF ABBREVIATIONS --- p.8 / Chapter I. --- INTRODUCTION --- p.9 / Chapter I.A. --- Menopause --- p.9 / Chapter I.A.1. --- Definition of the Menopause --- p.9 / Chapter I.A.2. --- Pathophysiology of Ovarian Failure --- p.10 / Chapter I.B. --- Effects of the Menopause --- p.13 / Chapter I B.1. --- Acute Effects --- p.13 / Chapter I.B.2. --- Medium Term Effects --- p.14 / Chapter I.B.3. --- Chronic Effects --- p.15 / Chapter I.B.3.a. --- Osteoporosis --- p.15 / Chapter I.B.3.b. --- Coronary Artery Disease (CAD) --- p.17 / Chapter I.C. --- Management of the Menopause --- p.19 / Chapter I.C.1. --- Hormone Replacement Therapy --- p.21 / Chapter I.C.2. --- Oestrogens --- p.22 / Chapter I.C.2.a. --- Oral Oestrogens --- p.22 / Chapter I.C.3. --- Progestogens --- p.24 / Chapter I.C.3.a. --- Combined Oestrogen and Progestogen Therapy --- p.24 / Chapter I.C.4. --- Complications and Contraindications to Hormone Replacement Therapy --- p.26 / Chapter II. --- LITERATURE REVIEW --- p.34 / Chapter II.A. --- Atherosclerosis --- p.35 / Chapter II.B. --- Risk Factors for Coronary Artery Disease --- p.37 / Chapter II.B.1. --- Age and Sex --- p.38 / Chapter II.B.2. --- Age at Menopause --- p.38 / Chapter II.B.3. --- Family History --- p.38 / Chapter II.B.4. --- Serum Lipids --- p.39 / Chapter II.B.5. --- Blood Pressure --- p.39 / Chapter II.B.6. --- Smoking --- p.40 / Chapter II.B.7. --- Diabetes Mellitus --- p.40 / Chapter II.C. --- The Effect of the Menopause on Risk Factors for Coronary Heart Disease --- p.41 / Chapter II.C.1. --- The Effect of the Menopause on Lipids and Lipoproteins --- p.41 / Chapter II.C.2. --- The Effect of the Menopause on Glucose and Insulin Metabolism --- p.43 / Chapter II.C.3. --- The Effect of the Menopause on Coagulation --- p.44 / Chapter II.C.4. --- The Effect of the Menopause on the Arterial Wall --- p.45 / Chapter II.D. --- The Risk of Coronary Artery Disease After the Menopause --- p.46 / Chapter II.D.1. --- The Effect of the Menopause on Peripheral Vascular Disease (PVD) --- p.47 / Chapter II.E. --- The Effect of the Hormone Replacement Therapy on Coronary Artery Disease Risk --- p.49 / Chapter II.F. --- The Mechanism of Cardioprotection of Oestrogen --- p.63 / Chapter II.F.1. --- The Indirect Effect of the Hormone Replacement Therapy on the Cardiovascular System --- p.64 / Chapter II.F.1.a. --- The Effect on Lipids and Lipoproteins --- p.64 / Chapter II.F.1.b. --- The Effect on Coagulation and Fibrinolysis --- p.66 / Chapter II.F.1.c. --- The Effect on Insulin and Glucose Metabolism --- p.67 / Chapter II.F.2. --- The Direct Effects of the Hormone Replacement Therapy on the Cardiovascular System --- p.67 / Chapter II.F.2.a. --- The Effect of Oestrogen on Vascular Contractility --- p.68 / Chapter II.F.2.b. --- The Effect of Oestrogen on Endothelial Dysfunction --- p.69 / Chapter II.F.2.C. --- Other Possible Direct Actions of Oestrogen --- p.72 / Chapter II.G. --- The Effects of Oestrogen on Blood Flow --- p.73 / Chapter III. --- RESEARCH PLAN --- p.78 / Chapter III.A. --- Formation of Research Hypothesis --- p.78 / Chapter III B. --- Research Hypothesis --- p.80 / Chapter III.C. --- Plan of Studies --- p.81 / Chapter III.C.1. --- Pilot Study --- p.81 / Chapter III.C.2. --- Randomized Controlled Study --- p.81 / Chapter IV. --- METHODOLOGY --- p.84 / Chapter IV.A. --- Pilot Study --- p.84 / Chapter IV.B. --- Study Population --- p.87 / Chapter IV.B.1. --- Recruitment of Cases --- p.88 / Chapter IV.B.1.a. --- Patients' Consent --- p.88 / Chapter IV.B.1.b. --- Method of Recruitment --- p.88 / Chapter IV.B.1.e. --- Research Methodology --- p.89 / Chapter IV.C. --- Ethical Considerations --- p.90 / Chapter IV.D. --- Samples Size Calculation --- p.92 / Chapter IV.E. --- Statistical Analysis --- p.93 / Chapter IV.F. --- Physical Principles of the Measurement of Peripheral Resistance --- p.94 / Chapter IV.F.1. --- The Arterial Analogue Waveform --- p.97 / Chapter IV.F.2. --- Peak Systolic Velocity --- p.98 / Chapter IV.G. --- Measurement of Pulsatility Index --- p.100 / Chapter IV.G.1. --- Establishment of Methodologies Used to Measure Peripheral Blood Flow --- p.105 / Chapter IV.G.2. --- Training of the Investigator --- p.107 / Chapter IV.H. --- Assay for Serum Oestradiol --- p.108 / Chapter IV.H.1. --- Principles --- p.108 / Chapter IV.H.2. --- Reagents --- p.109 / Chapter IV.H.3. --- Sample Dilution --- p.111 / Chapter IV.H.4. --- Calibration --- p.112 / Chapter IV.H.5. --- Quality Control --- p.112 / Chapter IV.H.6. --- Assay Validation --- p.113 / Chapter V. --- RESULTS --- p.115 / Chapter V.A. --- Pilot Study --- p.115 / Chapter V.B. --- Study Population --- p.118 / Chapter V.B.1. --- Characteristics of the Patients at Recruitment --- p.120 / Chapter V.B.2. --- Doppler Measurements --- p.123 / Chapter V.B.3. --- Pulsatility Index and Serum Oestradiol --- p.135 / Chapter VI. --- DISCUSSION --- p.137 / Chapter VI.A. --- Overview --- p.132 / Chapter VI.A.1. --- The Pilot Study --- p.133 / Chapter VI.B. --- Study Population --- p.136 / Chapter VI.C. --- Doppler Ultrasound as a Measurement of Vascular Resistance and Blood Flow --- p.142 / Chapter VI.C.1. --- Reliability of Doppler Study --- p.143 / Chapter VI.D. --- Pulsatility Index and Hormone Replacement Therapy --- p.146 / Chapter VI.E. --- Effects of Oestrogen on Pulsatility Index --- p.150 / Chapter VI.F. --- Conclusions --- p.152 / Chapter VI.G. --- Future Directions --- p.153 / REFERENCES --- p.155 / APPENDIX1 --- p.176