National differences in lipid response to postmenopausal hormone replacement therapy

Area of Science:

• Endocrinology
• Cardiovascular Health
• Pharmacology

Background:

• Hormone replacement therapy (HRT) is widely used by postmenopausal women.
• The effects of HRT on serum lipids and lipoproteins can vary.
• Understanding national differences in HRT response is crucial for personalized treatment.

Purpose of the Study:

• To investigate and compare the effects of transdermal HRT on serum lipids and lipoproteins in postmenopausal women across five European countries.
• To identify potential national variations in the response to hormone therapy.

Main Methods:

• A total of 567 healthy postmenopausal women from Belgium, Finland, the Netherlands, Sweden, and the UK participated.
• Participants received transdermal estradiol with various progestogens (norethisterone acetate, dydrogesterone) for 12 months.
• Serum levels of total cholesterol, HDL, HDL2, LDL, lipoprotein(a) (Lp(a)), and triglycerides were measured pre- and post-treatment.

Main Results:

• No significant national differences were observed in baseline lipid and lipoprotein levels.
• Transdermal HRT led to a decrease in total cholesterol, LDL, Lp(a), and triglycerides, and an increase in HDL and HDL2.
• Individual responses were dependent on pretreatment values, with British women exhibiting smaller changes in cholesterol, HDL, HDL2, and Lp(a) compared to other nationalities.

Conclusions:

• Significant national differences in serum lipid and lipoprotein response to transdermal HRT were identified.
• Caution is advised when generalizing HRT lipid data across different nations.
• Pretreatment lipid levels play a role in individual response variability to HRT.