Effects of continuous combined hormone replacement therapy on inflammation in hypertensive and/or overweight postmenopausal women.
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.
Koh
Kwang Kon
KK
Department of Cardiology, Gachon Medical School, Incheon, Korea. kwangk@ghil.com
Ahn
Jeong Yeal
JY
Jin
Dong Kyu
DK
Yoon
Byung-Koo
BK
Kim
Hyung Sik
HS
Kim
Dae Sung
DS
Shin
Mi-Seung
MS
Son
Ji Won
JW
Choi
In Suck
IS
Shin
Eak Kyun
EK
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
D015415:Biomarkers; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D045167:Progesterone Congeners; D011374:Progesterone; D017258:Medroxyprogesterone Acetate