Long-term effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity in healthy postmenopausal women.
OBJECTIVE
To study the effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity.


METHODS
Prospective, randomized, controlled study.


METHODS
Academic hospital.


METHODS
Healthy postmenopausal women with an intact uterus.


METHODS
For the first 12 months, the hormone replacement therapy group (n = 14) received oral E2, 1 mg daily, sequentially combined with 5 or 10 mg of dydrogesterone. Thereafter, they received oral E2, 2 mg daily, sequentially combined with 10 mg of dydrogesterone. The control group (n = 13) received no treatment. Data were collected at baseline and at 3, 12, and 15 months.


METHODS
Parameters of endothelial function and inflammatory activity.


RESULTS
During 12 months of follow-up, we observed decreases of 15% in plasma levels of endothelin-l, of 21% in soluble thrombomodulin, of 14% in von Willebrand factor, and of 12% in clottable fibrinogen in the hormone replacement therapy group compared with the control group. There was a 5% decrease in soluble E-selectin tevels. All significant changes were observed by 3 months and sustained after 15 months. Brachial artery flow-mediated vasodilatation and C-reactive protein levels did not change significantly.


CONCLUSIONS
Long-term combined hormone replacement therapy with E2 and dydrogesterone in healthy women was associated with sustained improvement in some aspects of endothelial function and in clottable fibrinogen levels.
van Baal
W M
WM
Department of Obstetrics and Gynecology, Institute for Cardiovascular Research, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Kenemans
P
P
Emeis
J J
JJ
Schalkwijk
C G
CG
Mijatovic
V
V
van der Mooren
M J
MJ
Vischer
U M
UM
Stehouwer
C D
CD
D004394:Dydrogesterone / Q000008:administration & dosage; D019040:E-Selectin / Q000097:blood; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology*; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012995:Solubility; D018180:Thrombomodulin / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
D019040:E-Selectin; D019332:Endothelin-1; D018180:Thrombomodulin; D014841:von Willebrand Factor; D004958:Estradiol; D005340:Fibrinogen; D004394:Dydrogesterone