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Effects of hormone replacement therapy on cardiovascular risk factors in postmenopausal women
1Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Taiwan, Republic of China.
Objective:
To investigate changes in plasma lipoprotein profile, hemostatic factors, platelet aggregation, endothelin-1, and cardiac function during postmenopausal sequential 6-month hormone replacement therapy (HRT).
Design:
Open longitudinal prospective study.
Setting:
Gynecologic department of a medical center.
Patient(S):
Twenty-one healthy hysterectomized postmenopausal women.
Intervention(S):
Oral E2 valerate (2 mg/d) combined with medroxyprogesterone acetate (MPA) (10 mg/d) during the last 10 days of each 21-day cycle. The treatment period was 6 months.
Main Outcome Measure(S):
Plasma lipoprotein profile, hemostatic parameters, platelet aggregation, endothelin-1, and left ventricular function.
Result(S):
After 6 months of treatment, total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol were significantly progressively reduced. Atherogenic indices of total cholesterol-to-high-density lipoprotein (HDL) cholesterol and LDL-to-HDL cholesterols also showed a significant progressive decline. The concentrations of antithrombin III were significantly increased. The maximum aggregation and slope of platelet aggregation were significantly reduced, but all parameters were more pronounced at 1 month of HRT than at 3 or 6 months. The concentrations of endothelin-1 were significantly reduced (by 16.1%). In the evaluation of left ventricular function, only peak atrial diastolic velocity was significantly reduced.
Conclusion(S):
Combined HRT had favorable effects on lipids and lipoproteins, hemostatic factors, platelet aggregation, endothelin-1, and left ventricular function. However, further study is needed to evaluate the long-term effects of combined HRT, especially on platelet aggregation and cardiac function.