Short-term effects of two continuous combined oestrogen-progestogen therapies on several cardiovascular risk markers in healthy postmenopausal women: a randomised controlled trial.
OBJECTIVE
To compare the short-term effects of two oral continuous combined oestrogen-progestogen treatment regimens on blood concentrations of several cardiovascular risk markers in healthy postmenopausal women.


METHODS
In a 12-week randomised controlled study, 48 healthy non-hysterectomised postmenopausal women, aged 41-58 years, received either no treatment (control group; n=16), or daily oral continuous combined treatment with 1 mg micronised 17beta-oestradiol plus 5 mg dydrogesterone (E/D group; n=18) or 0.625 mg conjugated equine oestrogens plus 5 mg medroxyprogesterone acetate (CEE/MPA group; n=14). Fasting blood sampling was performed at baseline and after 12 weeks of follow-up.


RESULTS
Compared with the control group, 12-week treatment with E/D or CEE/MPA reduced fibrinogen (-7.7%, p=0.004 and -3.3%, p=0.083, respectively), factor VII-act (-8.7%, p=0.14 and -9.7%, p=0.06, respectively), homocysteine (-20.5%, p=0.02 and -26.7%, p=0.005, respectively), and IGF-1 (-27.9%, p<0.001 and -18.1%, p=0.002, respectively), but increased factor VII-ag (+10.1%, p=0.03 and +4.4%, p=0.46, respectively), endothelin-1 (+15.2%, p=0.12 and +20.0%, p=0.13, respectively) and C-reactive protein (+88.8%, p=0.18 and +71.0%, p=0.44, respectively). Fibrinolytic factors were not affected by either hormone therapy (HT).


CONCLUSIONS
Short-term oral continuous combined therapy with oestradiol/dydrogesterone and conjugated equine oestrogens/medroxyprogesterone acetate had comparable effects on the investigated cardiovascular risk markers.
de Kraker
Alyde T
AT
Project Ageing Women and the Institute for Cardiovascular Research-Vrije Universiteit , VU University Medical Center, Amsterdam, The Netherlands.
Kenemans
Peter
P
Smolders
Raimond G V
RG
Kroeks
Maurice V A M
MV
van der Mooren
Marius J
MJ
D000328:Adult; D000941:Antigens / Q000378:metabolism; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood*; D004338:Drug Combinations; D004394:Dydrogesterone / Q000494:pharmacology*; D019332:Endothelin-1 / Q000378:metabolism; D004958:Estradiol / Q000494:pharmacology*; D015914:Estrogen Replacement Therapy; D005167:Factor VII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D017698:Postmenopause; D012307:Risk Factors; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000941:Antigens; D015415:Biomarkers; D004338:Drug Combinations; D019332:Endothelin-1; D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; C042580:factor VII clotting antigen; C472241:femoston; C037742:plasmin-plasmin inhibitor complex; D006710:Homocysteine; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D005167:Factor VII; D005340:Fibrinogen; D002097:C-Reactive Protein; D004394:Dydrogesterone; D017258:Medroxyprogesterone Acetate; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin