Abstract
Objective
To compare the short-term effects of two oral continuous combined oestrogen–progestogen
treatment regimens on blood concentrations of several cardiovascular risk markers
in healthy postmenopausal women.
Study design
In a 12-week randomised controlled study, 48 healthy non-hysterectomised postmenopausal
women, aged 41–58 years, received either no treatment (control group; n = 16), or daily oral continuous combined treatment with 1 mg micronised 17β-oestradiol plus 5 mg dydrogesterone (E/D group; n = 18) or 0.625 mg conjugated equine oestrogens plus 5 mg medroxyprogesterone acetate (CEE/MPA group; n = 14).
Fasting blood sampling was performed at baseline and after 12 weeks of follow-up.
Results
Compared with the control group, 12-week treatment with E/D or CEE/MPA reduced fibrinogen
(−7.7%, p = 0.004 and −3.3%, p = 0.083, respectively), factor VII-act (−8.7%, p = 0.14 and −9.7%, p = 0.06, respectively), homocysteine (−20.5%, p = 0.02 and −26.7%, p = 0.005, respectively), and IGF-1 (−27.9%, p < 0.001 and −18.1%, p = 0.002, respectively), but increased factor VII-ag (+10.1%, p = 0.03 and +4.4%, p = 0.46, respectively), endothelin-1 (+15.2%, p = 0.12 and +20.0%, p = 0.13, respectively) and C-reactive protein (+88.8%, p = 0.18 and +71.0%, p = 0.44, respectively). Fibrinolytic factors were not affected by either hormone therapy
(HT).
Conclusions
Short-term oral continuous combined therapy with oestradiol/dydrogesterone and conjugated
equine oestrogens/medroxyprogesterone acetate had comparable effects on the investigated
cardiovascular risk markers.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Postmenopausal hormone therapy and mortality.N Engl J Med. 1997; 336: 1769-1775
- Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women.JAMA. 1998; 280: 605-613
- Estrogen plus progestin and the risk of coronary heart disease.N Engl J Med. 2003; 349: 523-534
- Effects of conjugated equine estrogen in postmenopausal women with hysterectomy. The Women's Health Initiative randomized controlled trial.JAMA. 2004; 291: 1701-1712
- Increased C-reactive protein levels during short-term hormone replacement therapy in healthy postmenopausal women.Thromb Haemost. 1999; 81: 925-928
- Impaired procoagulant-anticoagulant balance during hormone replacement therapy? A randomised, placebo-controlled 12-week study.Thromb Haemost. 2000; 83: 29-34
- Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974–2000.Fertil Steril. 2001; 75: 898-915
- Cardiovascular risk factors during sequentially combined 17β oestradiol and dydrogesterone (Femoston®); results from a one-year study in postmenopausal women.Maturitas. 1997; 26: 125-132
- A randomised controlled study of the effects of 17β-estradiol–dydrogesterone on plasma homocysteine in postmenopausal women.Obstet Gynecol. 1998; 91: 432-436
- The effects of 17 beta-oestradiol plus dydrogesterone compared with conjugated equine oestrogens plus medroxyprogesterone acetate on lipids, apolipoproteins and lipoprotein(a).Maturitas. 2004; 49: 253-263
- Gerinnungsphysiologische Schnellmethode zur Bestimmung des fibrinogens.Acta Haemat. 1957; 17: 237-246
- Effects of hormone replacement therapies on fibrinogen and plasma viscosity in postmenopausal women.Br J Haematol. 1998; 100: 577-581
- Menopausal status and haemostatic variables.Lancet. 1983; 1: 22-24
- Cardiovascular disease risk and hormone replacement therapy (HRT): a review based on randomised, controlled studies in postmenopausal women.Curr Med Chem. 2000; 7: 499-517
- Long-term influence of different postmenopausal hormone replacement regimens on serum lipids and lipoprotein(a): a randomised study.Br J Obstet Gynaecol. 1997; 104: 708-717
- Endogenous tissue-type plasminogen activator and risk of myocardial infarction.Lancet. 1993; 341: 1165-1168
- Association between increased estrogen status and increased fibrinolytic potential in the Framingham Offspring Study.Circulation. 1995; 91: 1952-1958
- Effects of oral and transdermal estrogen/progesterone regimens on blood coagulation and fibrinolysis in postmenopausal women. A randomized controlled trial.Arterioscler Thromb Vasc Biol. 1997; 17: 3071-3078
- C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women.N Engl J Med. 2000; 342: 836-843
- New markers for cardiovascular disease risk in women: impact of endogenous estrogen status and exogenous postmenopausal hormone therapy.J Clin Endocrinol Metab. 2003; 88: 2470-2478
- The effect of 17beta-estradiol on endothelial and inflammatory markers in postmenopausal women: a randomized, controlled trial.Atherosclerosis. 2002; 165: 301-307
- Effects of transdermal and oral oestrogen replacement therapy on C-reactive protein levels in postmenopausal women: a randomised, placebo-controlled trial.Thromb Haemost. 2002; 88: 605-610
- Homocysteine and risk of cardiovascular disease among postmenopausal women.JAMA. 1999; 281: 1817-1821
- Increased plasma homocysteine after menopause.Atherosclerosis. 2000; 149: 163-168
- Plasma endothelin determination as a prognostic indicator of 1 year mortality after acute myocardial infarction.Circulation. 1994; 89: 1573-1579
- Postmenopausal hormonal replacement decreases plasma levels of endothelin-1.J Clin Endocrinol Metab. 1995; 80: 3384-3387
- Circulating concentrations of insulin-like growth factor and risk of breast cancer.Lancet. 1998; 351: 1393-1396
- Low serum Insulin-Like Growth Factor I is associated with an increased risk of ischemic heart disease. A population-based case–control study.Circulation. 2002; 106: 939-944
- Effects of sex and age on the 24-h profile of growth hormone secretion in man: importance of endogenous estradiol concentrations.J Clin Endocrinol Metab. 1987; 64: 51-58
- Modifications of serum IGF-1 IGFBPs and SHBG levels by different HRT regimens.Maturitas. 2003; 45: 283-291
Article info
Publication history
Published online: November 12, 2008
Accepted:
October 5,
2008
Received in revised form:
June 24,
2008
Received:
July 25,
2007
Identification
Copyright
© 2008 Published by Elsevier Inc.
