Cardiovascular effects of tibolone: a selective tissue estrogenic activity regulator.
Traditionally, it was accepted that long-term hormone replacement therapy (HRT) has a cardiovascular beneficial effect in postmenopausal women with and without coronary artery disease (CAD). However, randomized trials in postmenopausal women have not shown any benefit in either primary or secondary prevention of cardiovascular events. Therefore, these findings have raised the question of whether traditional HRT (i.e., estrogen and progesterone) has a cardioprotective effect in women at risk for or with established CAD. Concerns about the use of conventional HRT have led to a search for alternatives. Tibolone is a synthetic compound with estrogenic, androgenic, and progestogenic properties that relieves climacteric symptoms and prevents postmenopausal bone loss. Tibolone possesses a tissue-selective mechanism of action that differs from that of estrogen and/or progestogen. Unlike these compounds, tibolone's metabolites play a central role in its mode of action. Tibolone is widely used for HRT. However, its clinical impact on cardiovascular disease is still under study. The current review focuses on the effects of tibolone on the cardiovascular system and discusses clinical investigations with this compound in postmenopausal women.
Campisi
Roxana
R
Fundación Centro Diagnóstico Nuclear and Instituto Argentino de Diagnóstico y Tratamiento S.A., Argentina. rcampisi@fcdn.org.ar
Marengo
Fernando D
FD
D000818:Animals; D050197:Atherosclerosis / Q000517:prevention & control; D001777:Blood Coagulation / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects*; D003327:Coronary Disease / Q000188:drug therapy*; D020847:Estrogen Receptor Modulators / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D009652:Norpregnenes / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology*; D017539:Tunica Intima / Q000187:drug effects*
D020847:Estrogen Receptor Modulators; D009652:Norpregnenes; C027385:tibolone