Changes in remnant and high-density lipoproteins associated with hormone therapy and progression of coronary artery disease in postmenopausal women.
OBJECTIVE
This study examined the effect of hormone therapy (HT) on the plasma concentration of remnant lipoprotein cholesterol (RLP-C) and high-density lipoprotein (HDL) subpopulations and the contribution of HT-related changes in these lipoproteins to the progression of coronary heart disease (CHD) in postmenopausal women.


METHODS
Study participants were 256 women who completed the Estrogen Replacement and Atherosclerosis (ERA) trial, a placebo-controlled, randomized trial that examined the effects of 3.2 years of conjugated equine estrogen (CEE, 0.625 mg/day) or CEE (0.625 mg/day) plus medroxyprogesterone acetate (MPA, 2.5mg/day) on postmenopausal women with established coronary atherosclerosis. Quantitative coronary angiography and plasma RLP-C and HDL subpopulations were assessed at baseline and at follow-up.


RESULTS
Relative to placebo, both CEE and CEE+MPA caused a significant reduction in plasma RLP-C concentrations and a significant increase in alpha1 and alpha2 HDL subpopulations. However, in the HT-treated subjects, faster progression of coronary atherosclerosis was observed in women who experienced the greatest reductions in RLP-C and in prebeta1 HDL subpopulations.


CONCLUSIONS
Our data suggest that individual variability in RLP-C and HDL subpopulation response to HT is a predictor of CHD progression. Lipoprotein response to HT may be an indirect marker of susceptibility to other harmful effect of HT in postmenopausal women with established CHD or an indication of formation of dysfunctional lipoproteins.
Lamon-Fava
Stefania
S
Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, United States. stefania.lamon-fava@tufts.edu
Herrington
David M
DM
Reboussin
David M
DM
Sherman
Michelle
M
Horvath
Katalin
K
Schaefer
Ernst J
EJ
Asztalos
Bela F
BF
D000368:Aged; D002784:Cholesterol / Q000378:metabolism; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000097:blood*; D018450:Disease Progression; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008075:Lipoproteins, HDL / Q000096:biosynthesis*; D008875:Middle Aged; D010919:Placebos; D017698:Postmenopause
D004966:Estrogens, Conjugated (USP); D006728:Hormones; D008075:Lipoproteins, HDL; D010919:Placebos; D002784:Cholesterol