Effects of raloxifene therapy on plasma renin and aldosterone levels and blood pressure in postmenopausal women

OBJECTIVE: Blood pressure, which generally increases after menopause, is one of the best tools to characterize cardiovascular disease. The renin-aldosterone system plays a role in determining cardiovascular risk and the role of estrogen in the regulation of angiotensinogen gene expression and serum levels is well known. Raloxifene can induce endothelium-dependent vasodilation without affecting endothelium-independent vasorelaxation. The aim of the study was to investigate the effects of raloxifene on the renin-aldosterone system and blood pressure in postmenopausal women. DESIGNS: Forty women, 54-59 years of age, in physiological menopause for 6 months to 4 years, were enrolled in the study and treated with raloxifene 60 mg/day for 6 months. All had blood pressure less than 130/85 mm Hg at the start of the study. The women were divided into two groups: the first (group A; 20 women) with normal blood pressure and the second (group B; 20 women) with previous high blood pressure treated with antihypertensive drugs, not angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. RESULTS: No significant changes in plasma renin activity (PRA) or plasma concentrations of aldosterone were observed between the two groups after 6 months of raloxifene use. There was a slight reduction in PRA (11+/-4% for group A and 13+/-5% for group B) and in plasma levels of aldosterone (3.6+/-0.5% and 4.6+/-0.5%, respectively) with respect to basal values, but neither change was statistically significant. CONCLUSIONS: The results of the present study show that raloxifene at 60 mg/day dose is well tolerated and has no clinical impact on blood pressure, PRA or aldosterone in postmenopausal women