CONTINUOUS COMBINED AND SEQUENTIAL ESTRADIOL AND NORETHINDRONE ACETATE TREATMENT OF POSTMENOPAUSAL WOMEN - EFFECT ON PLASMA-LIPOPROTEINS INA 2-YEAR PLACEBO-CONTROLLED TRIAL
N. Munkjensen et al., CONTINUOUS COMBINED AND SEQUENTIAL ESTRADIOL AND NORETHINDRONE ACETATE TREATMENT OF POSTMENOPAUSAL WOMEN - EFFECT ON PLASMA-LIPOPROTEINS INA 2-YEAR PLACEBO-CONTROLLED TRIAL, American journal of obstetrics and gynecology, 171(1), 1994, pp. 132-138
OBJECTIVE: Our purpose was to examine the effects of postmenopausal es
trogen therapy supplemented with progestogen on plasma lipoprotein lev
els. STUDY DESIGN: One hundred thirteen women were randomized to recei
ve either placebo or a combination of 17 beta-estradiol and norethindr
one acetate administered continuously (Kliogest) or sequentially (Tris
equens). Plasma lipoprotein levels were measured at baseline and after
2 years of treatment and compared by analysis of variance. RESULTS: H
ormone therapy lowered plasma cholesterol levels (p < 0.001) and low-d
ensity lipoprotein cholesterol (Kliogest, p < 0.001; Trisequens, p < 0
.01), whereas high-density lipoprotein cholesterol levels were unchang
ed (Trisequens) or reduced (Kliogest, p < 0.01), primarily because of
a decrease in the high-density lipoprotein-2 subfraction (p < 0.05). L
ow-density lipoprotein/high-density lipoprotein cholesterol ratios rem
ained unchanged. CONCLUSIONS: Although hormonal replacement therapy wi
th estradiol combined with norethindrone acetate eliminated the increa
se in high-density lipoprotein cholesterol levels observed with estrog
en monotherapy, the reductions in low-density lipoprotein cholesterol
concentrations still suggest reduced cardiovascular risk, according to
the National Cholesterol Education Program and to recent observations
indicating that risk is not necessarily inversely proportional to hig
h-density lipoprotein cholesterol levels.