The effects of estrogen and selective estrogen receptor modulators on cardiovascular risk factors.
Raloxifene, a selective estrogen receptor modulator, favorably alters several markers of cardiovascular risk in healthy postmenopausal women. While many of its effects are similar to those of conventional hormone replacement therapy (HRT), there are also important differences. Raloxifene lowered low-density lipoprotein cholesterol levels similarly to estrogen. However, raloxifene lacked the potentially beneficial effects of HRT on high-density lipoprotein cholesterol levels and plasminogen activation inhibitor-1, as well as the potentially adverse effects of HRT on triglycerides and C-reactive protein. Raloxifene also had a potentially beneficial fibrinogen-lowering effect not seen with conventional HRT. The net effect of these differences is unclear. Proof that raloxifene or HRT reduces the risk of heart disease must await the results of ongoing clinical trials with cardiovascular event end points.
Walsh
B W
BW
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. bwwalsh@bics.bwh.harvard.edu
D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008593:Menopause; D017698:Postmenopause; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000627:therapeutic use
D020847:Estrogen Receptor Modulators; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D020849:Raloxifene Hydrochloride