Effect of postmenopausal hormone replacement on atherosclerosis in femoral arteries.
OBJECTIVE
On the basis of epidemiological and experimental data, it has been supposed that hormone replacement therapy (HRT) inhibits atherosclerosis in postmenopausal women. This randomized controlled trial examined whether 1 mg 17beta-estradiol daily, combined cyclically with 0.025 mg gestodene in every month (HRT 1), or in every third month (HRT 2) slows the increase of intima-media thickness in femoral arteries compared with no HRT.


METHODS
Healthy postmenopausal women (n=321) with an increased risk for future vascular disease as indicated by >1 mm of intima-media thickness in the carotid arteries were equally randomized to one of the three groups for 48 weeks. Ultrasound scans of femoral arteries were recorded at study start and study end, together with a thorough clinical examination and laboratory work-up.


RESULTS
Complete scans were obtained in 260 of the 264 subjects who participated until study end. Mean maximum intima-media thickness of four femoral artery segments (common and superficial, both sides) was 0.93+/-0.37 mm (mean+/-S.D.) at study start. It increased by 0.02+/-0.05, 0.02+/-0.05, and 0.03+/-0.05 mm in the HRT 1, HRT 2 and no HRT groups, respectively (HRT 1 versus no HRT, HRT 2 versus no HRT; both P>0.2). Compared with no HRT, HRT significantly lowered follicle stimulating hormone, low-density lipoprotein cholesterol, and fibrinogen.


CONCLUSIONS
In this 1-year trial, irrespective of the progestogen dose used, HRT with 1 mg 17 beta-estradiol did not inhibit progression of femoral artery atheroslerosis in postmenopausal women with subclinical vascular disease.
Angerer
Peter
P
Klinikum der Universität München, Institut und Poliklinik für Arbeits- und Umweltmedizin, Medizinische Klinik-Innenstadt, Ziemssenstrasse 1, 80336 München, Germany. peter.angerer@arbeits.med.uni-muenchen.de
Störk
Stefan
S
Kothny
Wolfgang
W
von Schacky
Clemens
C
D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000517:prevention & control*; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D005340:Fibrinogen / Q000378:metabolism; D005640:Follicle Stimulating Hormone / Q000097:blood; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D009652:Norpregnenes / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000502:physiology; D014463:Ultrasonography
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D009652:Norpregnenes; D014280:Triglycerides; C033273:Gestodene; D004958:Estradiol; D005340:Fibrinogen; D005640:Follicle Stimulating Hormone; D002784:Cholesterol