Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint

Lip, Gregory Y.H.; Beevers, Gareth; Zarifis, John

doi:10.1111/j.1365-2796.1995.tb01216.x

Cited by 20 publications

(12 citation statements)

References 73 publications

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“…6,16 It suggests that recommendations for concomitant progestin therapy prescribed to women with an intact uterus may not diminish any Lp(a)-mediated impact on cardiovascular disease risk. 20,24,39 The treatment effects of hormone therapy on Lp(a) were fairly consistent at 1 and 3 years for women who adhered to their medication. One possible exception may be for women taking micronized progesterone; in PEPI, these women had a 25.7% mean relative treatment-related reduction in Lp(a) at 36 months compared with 16.4% mean reduction at 12 months, a difference that reached nominal statistical significance (Pϭ.03).…”

Section: Discussionmentioning

confidence: 96%

Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration

Marcovina²,

et al. 1998

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Background-Postmenopausal hormone therapy has been reported to decrease levels of lipoprotein (Lp)(a) in cross-sectional studies and small or short-term longitudinal studies. We report findings from a large, prospective, placebo-controlled clinical trial that allows a broad characterization of these effects for four regimens of hormone therapy. Methods and Results-The Postmenopausal Estrogen/Progestin Interventions study was a 3-year, placebo-controlled, randomized clinical trial to assess the effect of hormone regimens on cardiovascular disease risk factors in postmenopausal women 45 to 65 years of age. The active regimens were conjugated equine estrogens therapy at 0.625 mg daily, alone or in combination with each of three regimens of progestational agents: medroxyprogesterone acetate (MPA) at 2.5 mg daily (ie, continuous MPA), MPA at 10 mg days 1 to 12 (ie, cyclical MPA), and micronized progesterone at 200 mg days 1 to 12. Plasma levels of Lp(a) were measured at baseline (nϭ366), 12 months (nϭ354), and 36 months (nϭ342). Assignment to hormone therapy resulted in a 17% to 23% average drop in Lp(a) concentrations relative to placebo (PϽ.0001), which was maintained across 3 years of follow-up. No significant differences were observed among the four active arms. Changes in Lp(a) associated with hormone therapy were positively correlated with changes in LDL cholesterol, total cholesterol, apolipoprotein B, and fibrinogen levels and were similar across subgroups defined by age, weight, ethnicity, and prior hormone use. Conclusions-Postmenopausal estrogen therapy, with or without concomitant progestin regimens, produces consistent and sustained reductions in plasma Lp(a) concentrations. (Circulation. 1998;97:979-986.)

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Section: Discussionmentioning

confidence: 96%

Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration

Marcovina²,

et al. 1998

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“…Sex hormones have important and complex actions on the cardiovascular system and the cardiovascular risk factors (Lip et al ., 1995). Sex hormone replacement is mostly initiated and monitored on symptomatic basis and therefore late or inadequate replacement is possible.…”

Section: Conclusion On the Role Of Gh Deficiency In Cardiovascular Dmentioning

confidence: 99%

Cardiovascular disease and risk factors in adults with hypopituitarism

Beshyah¹,

Johnston²

1999

Clinical Endocrinology

119

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In 1992, Cuneo et al. (1992) reviewed, in this journal, the consequences of growth (GH) deficiency during adult life and coined the term 'Growth hormone deficiency (GHD) syndrome in adults'. Limited information was available then on cardiovascular disease and risk factors in adults with hypopituitarism. More data have been published since on cardiovascular morbidity in symptom-free hypopituitary adults. Several groups have also published results on the effects of GH therapy on cardiac structure and function and on the cardiovascular risk factors.We shall review here the epidemiological and experimental data on cardiovascular morbidity and mortality in adult hypopituitarism. We shall also examine the prevalence of cardiovascular risk factors in this group of patients and their potential causes focusing on the possible role of GH deficiency and the effects of GH replacement. Cardiovascular disease in hypopituitarism

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“…[10][11][12] Long-term administration of HRT may reduce the risk of developing these conditions via favourable effects on bone metabolism and cardiovascular risk factors (ie, raising HDL, lowering of LDL, total cholesterol, fibrinogen and PAI-1, 1,[13][14][15][16] ). Additionally, HRT relieves postmenopausal symptoms such as vaginal dryness, loss of libido, hot flushes and depression.…”

Section: Discussionmentioning

confidence: 99%

Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

1999

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Co-administration of antihypertensive drug therapy and hormonal replacement therapy (HRT) is frequent in postmenopausal women but it is not known whether HRT interacts with concomitant antihypertensive therapy. The present study was designed to investigate efficacy and safety of the ACE inhibitor moexipril in comparison to placebo in hypertensive, postmenopausal women on HRT.After a 4-week placebo run-in phase, 95 postmenopausal women (35-74 years of age) who had a sitting diastolic blood pressure (BP) of 95-114 mm Hg and were treated with HRT were randomised to a 12-week treatment with moexipril 15 mg or placebo. Efficacy and safety were assessed by measuring changes in sitting BP and metabolic parameters associated with cardiovascular disease including triglycerides, total cholesterol, HDL, LDL, total cholesterol/HDL ratio and glucose. Adverse events were recorded continuously.After 12 weeks of treatment, moexipril 15 mg was significantly more effective in reducing sitting systolic

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Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint

Cited by 20 publications

References 73 publications

Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration

Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration

Cardiovascular disease and risk factors in adults with hypopituitarism

Co-administration of an ACE-inhibitor (moexipril) and hormonal replacement therapy in postmenopausal women

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