title: Effects of continuous combined hormone replacement therapy on inflammation in hypertensive and/or overweight postmenopausal women.
abstract: OBJECTIVE
  We observed that estrogen did not show cardioprotective benefits in type 2 diabetic postmenopausal women. We hypothesized that hypertensive and/or overweight women may be less likely to realize cardiovascular benefits from estrogen.
  
  
  RESULTS
  We administered micronized progesterone (MP) 100 mg or medroxyprogesterone acetate (MPA) 2.5 mg with conjugated equine estrogen (CEE) 0.625 mg daily during 2 months to 35 hypertensive and/or overweight postmenopausal women with a randomized, double-blind, crossover design. With significant changes of lipoproteins, CEE+MP or MPA significantly improved flow-mediated dilation and reduced plasma E-selectin, intercellular adhesion molecule type-1, monocyte chemoattractant protein-1, and tumor necrosis factor-alpha levels (P<0.001, P<0.001, P=0.021, P<0.001, and P<0.001 by ANOVA, respectively), but not C-reactive protein and fibrinogen levels. Of note, there were no significant differences between each therapy regarding these effects. However, the magnitude of improvement of flow-mediated dilation in these women was less than in healthy postmenopausal women and more than in diabetic postmenopausal women reported by our previous studies. The effects of CEE+MP or MPA on inflammatory markers were comparable to healthy postmenopausal women, but not comparable to diabetic postmenopausal women.
  
  
  CONCLUSIONS
  Estrogen combined with synthetic progestin significantly improved flow-mediated brachial artery dilator response and reduced inflammation markers in hypertensive and/or overweight women, comparable to estrogen combined with natural progesterone.
authors.affiliation: Department of Cardiology, Gachon Medical School, Incheon, Korea. kwangk@ghil.com
authors.forename: Kwang Kon
authors.initials: KK
authors.lastname: Koh
authors.forename: Jeong Yeal
authors.initials: JY
authors.lastname: Ahn
authors.forename: Dong Kyu
authors.initials: DK
authors.lastname: Jin
authors.forename: Byung-Koo
authors.initials: BK
authors.lastname: Yoon
authors.forename: Hyung Sik
authors.initials: HS
authors.lastname: Kim
authors.forename: Dae Sung
authors.initials: DS
authors.lastname: Kim
authors.forename: Mi-Seung
authors.initials: MS
authors.lastname: Shin
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Son
authors.forename: In Suck
authors.initials: IS
authors.lastname: Choi
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000379:methods; D006736:Horses; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D007249:Inflammation / Q000097:blood / Q000188:drug therapy; D008055:Lipids / Q000097:blood; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D017698:Postmenopause / Q000097:blood / Q000187:drug effects*; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D014666:Vasomotor System / Q000187:drug effects
chemical_list: D015415:Biomarkers; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D045167:Progesterone Congeners; D011374:Progesterone; D017258:Medroxyprogesterone Acetate