Lipid profiles and endothelial function with low-dose hormone replacement therapy in postmenopausal women at risk for coronary artery disease: a randomized trial.
OBJECTIVE
To compare the effect of low (0.3 mg) and commonly prescribed (0.625 mg) doses of conjugated equine estrogens (CEE) on brachial artery flow-mediated dilation and lipid profiles.


RESULTS
Twenty-five postmenopausal women (mean age, 65+/-6 years) at risk for coronary artery disease (CAD) (> or =2 established risk factors) entered a double-blind crossover study. Brachial artery endothelial function was evaluated by means of high-resolution vascular echography. Both CEE doses significantly decreased total cholesterol (-13%, 0.3 mg; -15%, 0.625 mg), low-density lipoprotein-cholesterol (LDL-C) (-15%, 0.3 mg; -16%, 0.625 mg), and lipoprotein(a) (-28%, 0.3 mg; -39%, 0.625 mg) values from baseline levels. Both treatments increased high-density lipoprotein-cholesterol (HDL-C) (5%, 0.3 mg; 7%, 0.625 mg) and triglycerides (3%, 0.3 mg; 8%, 0.625 mg). There was no dose effect for changes in the LDL-C/HDL-C ratio (-21%, 0.3 mg; -23%, 0.625 mg). Both doses improved brachial artery dilation during reactive hyperemia by 63% over baseline.


CONCLUSIONS
In women at risk for CAD, low-dose hormone replacement treatment (HRT) improves lipid profiles and brachial artery endothelial function comparably to the most commonly prescribed dose. The benefit:risk ratio of low-dose HRT provides an attractive option for postmenopausal women at risk for CAD.
Mercuro
Giuseppe
G
Cardiovascular Research Unit, Department of Internal Medicine, San Raffaele Hospital, Rome, Italy.
Vitale
Cristiana
C
Fini
Massimo
M
Zoncu
Sandra
S
Leonardo
Filippo
F
Rosano
Giuseppe M C
GM
D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000517:prevention & control*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000502:physiology*; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D012306:Risk; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects*
D004966:Estrogens, Conjugated (USP); D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol