Blood pressure and cardiovascular risk factors in women treated for climacteric symptoms with acupuncture, phytoestrogens, or hormones

Objective: To evaluate the response of cardiovascular risk factors to the treatment of climacteric symptoms. Methods: In this prospective study, women reporting climacteric symptoms were randomized to 3 months of treatment with either acupuncture (n = 19), phytoestrogens (75 mg soy isoflavones, BID; n = 22), or low-dose hormone therapy (HT; 0.3 mg conjugated equine oestrogens plus 1.5 mg medroxyprogesterone acetate; n = 20). Greene's climacteric scale, blood pressure (BP), lipids, glucose, insulin, and homeostatic model assessment of insulin resistance were assessed before and after treatment. Observed changes were compared by analysis of variance. Results: HT and acupuncture reduced Greene climacteric score to a similar extent, but the effect of phytoestrogens was significantly lower (P < 0.05). With acupuncture, systolic (-7.4 +/- 15.3 mm Hg; P < 0.05) and diastolic BP (-8.3 +/- 7.7mm Hg; P < 0.01) decreased, and the same occurred with phytoestrogens (-8.4 +/- 9.0 mm Hg [P P < 0.01]). Neither BP systolic (1.9 +/- 17.5 mm Hg) nor BP diastolic (-1.4 +/- 9.6 mm Hg) changed during HT. Low-density lipoprotein cholesterol decreased with phytoestrogens (-9.9 +/- 19.6 mg/dL; P < 0.05), and triglycerides increased with both HT (34.5 +/- 12.2 mg/dL; P < 0.01) and phytoestrogens (17.41 +/- 24.4 mg/dL; P < 0.01). A slight but significant increase in homeostatic model assessment of insulin resistance (0.14 +/- 0.5; P < 0.05) was observed after HT. Conclusions: Treatment of climacteric symptoms with acupuncture and phytoestrogens, but not HT, is associated with a clear BP reduction, and phytoestrogens with potentially positive alterations in low-density lipoprotein cholesterol level.