Lipid levels and cardiovascular risk in elderly women: a general population study of the effects of hormonal treatment and lipid-lowering agents.
OBJECTIVE
To evaluate plasma lipid levels in elderly women in the general population as a function of use of lipid-lowering agents (LLA) and hormone therapy (HT).


METHODS
A total of 4271 women aged over 65 years were recruited from three French cities. Analyses were performed after stratification by LLA treatment and HT and adjusting for a large range of sociodemographic and clinical factors.


RESULTS
Fifteen percent of women currently used HT (78% transdermal estradiol), and 30% were taking LLA. In this population, 4.6% of women were taking both HT and LLA (fibrate for 2.4% and statin for 2.2%). In non-LLA-treated women, current HT was associated with lower total cholesterol, low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) compared to never users. Women treated with LLA also had lower total cholesterol, LDL-C, and non-HDL-C compared to non-LLA users, whereas triglyceride levels were the highest in statin users and lowest in fibrate users. Fibrate use was associated with a more favorable lipid pattern than statin treatment independently of HT use. In women without coronary heart disease or diabetes, HT, statin or fibrate use were associated with lower LDL-C level risk based on National Cholesterol Education Program guidelines (adjusted odds ratio (OR) = 0.67 (95% confidence interval (CI) = 0.53-0.85), 0.38 (95% CI = 0.29-0.47), and 0.32 (95% CI = 0.25-0.42), respectively) with a possible interaction between fibrate and HT (0.18 (95% CI = 0.10-0.30)).


CONCLUSIONS
Estradiol-based HT may lower atherogenic lipoproteins in postmenopausal women. In primary prevention of coronary heart disease, combining HT and a fibrate may provide additional benefits compared to fibrate use.
Dupuy
A-M
AM
Inserm U888, Montpellier, France.
Carrière
I
I
Scali
J
J
Cristol
J-P
JP
Ritchie
K
K
Dartigues
J-F
JF
Gambert
P
P
Ancelin
M-L
ML
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood*; D002995:Clofibric Acid / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides; D002995:Clofibric Acid; D002784:Cholesterol