The Scope E-Newsletter January 2010 Dr. Mountain Leads HRT Study Funded by American Heart Association

Deidra Mountain, PhD Several years ago, clinical faculty in Surgery's Division of Vascular/Transplant Surgery discovered that women receiving hormone replacement therapy (HRT) who presented with vascular disease requiring intervention often had more adverse outcomes after their procedures than women who were not taking HRT. They found that women taking HRT experience failed vascular interventions because of the development of intimal hyperplasia, a thickening of the arterial wall, causing arterial stenosis, a decrease in vessel diameter and reduced blood flow.

Investigators in the Vascular Research Laboratory are now on a mission to identify the vascular cell mechanisms that are influenced by estrogen and progesterone. Led by Deidra Mountain, PhD, Assistant Professor of Surgery's Division of Vascular/Transplant Surgery and Research Scientist in the Vascular Research Laboratory, their goal is to develop possible therapeutic interventions to improve outcomes for these affected women.

Vascular disease is the leading cause of morbidity in the U.S., and cases are expected to rise by 75 percent over the next 35 years. Although estrogen was the second most frequently prescribed medication in the U.S. in 2000, surveys show 58 percent of women stopped taking HRT due to possible increased risks for breast cancer and heart disease; however, many women still use HRT for relief of menopausal symptoms.

Dr. Mountain believes the need for therapeutic intervention to HRT's adverse effects on vascular interventions is increasingly important, and the American Heart Association (AHA) agrees. Dr. Mountain's project is funded in part through a four-year Scientist Development Grant from the AHA. Comments for the grant approval included that the problem is of "significant clinical importance" given the prevalence of vascular disease and the seemingly contradictory reports of the risks and benefits associated with HRT use. Additionally, the reviewers commented on the "supportive environment" at the UT Graduate School of Medicine, including the availability of resources and the dedication of Surgery faculty, including Mitchell Goldman, MD, Chair, to advance the practice of medicine through basic, translational and clinical research.

"Things can be discovered and solved in a basic science laboratory that are often left unanswered in retrospective or prospective clinical studies alone," Dr. Mountain said. "But if it stays in the laboratory and never makes it back to the clinic, then what was the point? What is gratifying about the work we do here is the collaboration between basic, translational, and clinical science all working together."