title: The effect of 17beta-estradiol on endothelial and inflammatory markers in postmenopausal women: a randomized, controlled trial.
abstract: BACKGROUND
  Intervention trials in postmenopausal women with coronary artery disease have failed to demonstrate beneficial effects of hormone replacement therapy (HRT) on the course of disease, potentially due to pro-inflammatory effects of conjugated equine estrogens. We characterized the effects of 48 weeks treatment with two estradiol-based HRT regimens on nonspecific (high sensitivity C-reactive protein [hs-CRP], blood sedimentation rate [BSR], fibrinogen) and specific endothelial markers (cell adhesion molecules: ICAM-1, VCAM-1, E-selectin).
  
  
  RESULTS
  Postmenopausal women randomly received either 1 mg 17beta-estradiol daily plus 25 microg gestodene for the last 12 days of each 28 day cycle (=standard dose progestin; n=65), or gestodene added each third cycle only (=low dose progestin; n=65), or no HRT (n=73). Both HRT regimens reduced levels of ICAM-1 (-9%), VCAM-1 (-9%), E-selectin (-11%), fibrinogen (-12%), BSR (-5%). No effect was observed on hs-CRP levels in any group. In smokers, E-selectin remained unchanged whereas ICAM-1 and VCAM-1 were lowered. Subjects on antihypertensive or lipid lowering medication showed effects comparable to the whole cohort. Effects of low and standard dose progestin were not different.
  
  
  CONCLUSIONS
  We conclude that a combination therapy with 1 mg 17beta-estradiol favourably affects the vascular inflammation processes as indicated by a neutral effect on hs-CRP and reduction of cell adhesion molecules.
authors.affiliation: Medizinische Klinik, Klinikum der Ludwig-Maximilians Universität München-Innenstadt, München, Germany. s.stoerk@medizin.uni-wuerzburg.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.forename: Clemens
authors.initials: C
authors.lastname: von Schacky
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
mesh_terms: D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects; D002340:Carotid Artery Diseases / Q000097:blood* / Q000209:etiology; D015815:Cell Adhesion Molecules / Q000097:blood* / Q000187:drug effects; D004958:Estradiol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D045167:Progesterone Congeners; D004958:Estradiol; D002097:C-Reactive Protein