Cardiovascular Risk Factors During Estrogen-Norethindrone and Cholecalciferol Treatment

Abstract

The effect of cholecalciferol and estrogen-norethindrone treatment on total cholesterol level, high-density lipoprotein cholesterol level, blood pressure, and body mass index was investigated in 74 postmenopausal women in a double-blind, randomized trial. Blood pressure and body mass index did not change throughout the study. We demonstrated a decrease (11%) in serum cholesterol level after 1 year of treatment with estrogen-norethindrone. When this treatment was combined with cholecalciferol, a similar decrease (13%) was observed. The hypocholesterolemic effect was correlated to body mass index in a way that indicated the most pronounced decrease in lean women. The high-density lipoprotein cholesterol/total cholesterol fraction increased by 45% after 1 year of estrogen-norethindrone treatment, while an increase of 25% after 1 year was seen when cholecalciferol was added to the treatment. The latter increase was not different from a similar increase in the placebo group. The possible dyslipidemic effect of cholecalciferol, along with the risk of hypercalcemia, emphasizes the caution necessary in cholecalciferol treatment.

Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women

“…The current study used a double-blind, randomised, placebocontrolled design with adequate power to detect small changes in clinic and ambulatory blood pressure produced by different doses of a C21 progestogen administered in a cyclical regimen in doses spanning the usual clinical dose range combined with a fixed daily dose of oral oestrogen. The results of the current study are consistent with those of previous studies, including the PEPI study, which have found no change [2][3][4][5][6][7][8][9][10]12 or a reduction [24][25][26]29 in blood pressure associated with the addition of a progestogen to 'replacement' doses of oestrogen.…”

“…Collectively, previous studies have variably shown no change, 1-12 a decrease 1,2,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] or an increase 4,9,11,21,[30][31][32][33][34][35] in blood pressure with various combinations of HRT. Unfortunately, few of the previous studies have been designed to differentiate between the effects on blood pressure of the individual oestrogen ('natural', conjugated equine or semisynthetic) and progestogen (C21 or C19 derivatives administered as cyclical or continuous therapy) components of the regimen when these preparations have been administered in combination.…”

Effects of Vitamin D on Cardiovascular Risk and Oxidative Stress

“…Myrup and colleagues accompanied 74 postmenopausal healthy Danish women (>70 years) for 18 months. The protocol of supplementation with 0.5 μg of 1,25(OH)2D/day for 1 year presented no statistical significance for any of the parameters analyzed (i.e., total cholesterol (TC); high-density lipoprotein cholesterol (HDL-c); blood pressure at 0, 3, 6, 9, 12, and 18 months) [ 51 ]. On the other hand, a study of 463 postmenopausal women (45–75 years; mean age 58 years) showed that women with low 25(OH)D levels (<30 ng/mL) had higher levels of TC ( p = 0.031), triglycerides (OR 1.55, 95%CI = 1.13–2.35), and HDL-c (OR 1.60, 95%CI = 1.19–2.40) [ 6 ].…”

Influence of vitamin D supplementation on plasma lipid profiles: A meta-analysis of randomized controlled trials

“…Among them, one study met all our inclusion criteria but could not be incorporated into the meta-analysis because it reported quartiles instead of variance [12]. 5 more trials were excluded because vitamin D was a part of mixed intervention [13-17]. Other 4 studies were not included because they focused on the hemodialysis patients [18-21].…”