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The effect of hormone replacement therapy and simvastatin on plasma homocysteine

Eftihia Sbarouni1, Zenon S Kyriakides, Dimitrios Th Kremastinos

  • 12nd Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece. elbee@ath.forthnet.gr

Journal of Women'S Health (2002)
|March 19, 2005
PubMed

Insights

Hormone replacement therapy (HRT) effectively lowers homocysteine levels in postmenopausal women with coronary artery disease (CAD). Simvastatin alone did not impact homocysteine, suggesting HRT

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Homocysteine is a potential independent risk factor for coronary artery disease (CAD) in both men and women.
  • Homocysteine levels exhibit sex-based differences and are influenced by hormonal status, being lower in women, during pregnancy, and higher during menopause.

Purpose of the Study:

  • To evaluate the impact of hormone replacement therapy (HRT), simvastatin, and their combination on plasma homocysteine levels.
  • To assess the efficacy of HRT and simvastatin in postmenopausal women with hypercholesterolemia and CAD.

Main Methods:

  • A randomized, placebo-controlled study involving 16 postmenopausal women with CAD.
  • Participants received HRT (conjugated equine estrogens and medroxyprogesterone), simvastatin, or combination therapy for 8-week periods with 4-week washout intervals.
  • Plasma homocysteine levels were measured at the end of each treatment phase.

Main Results:

  • HRT, both alone and in combination with simvastatin, significantly reduced homocysteine levels compared to placebo (p < 0.05).
  • Simvastatin monotherapy showed no significant effect on homocysteine levels.
  • Combination therapy offered no additional benefit over HRT monotherapy.

Conclusions:

  • Oral HRT demonstrably reduces plasma homocysteine levels in postmenopausal women.
  • Simvastatin does not appear to affect homocysteine levels in this population.
  • HRT could be a potential therapeutic option for women with hypercholesterolemia and elevated homocysteine, pending further clinical validation.
Abstract

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