Wm. Van Baal et al., Long-term effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity in healthy postmenopausal women, FERT STERIL, 71(4), 1999, pp. 663-670
Objective: To study the effects of combined hormone replacement therapy on
markers of endothelial function and inflammatory activity.
Design: Prospective, randomized, controlled study.
Setting: Academic hospital.
Patient(s): Healthy postmenopausal women with an intact uterus.
Intervention(s): For the first 12 months, the hormone replacement therapy g
roup (n = 14) received oral 1 mg daily, sequentially combined with 5 or 10
mg of dydrogesterone. Thereafter, they received oral E-2, 2 daily, sequenti
ally combined with 10 mg of dydrogesterone. The control group (n = 13) rece
ived no treatment. Data were collected at baseline and at 3, 12, and 15 mon
ths.
Main Outcome Measure(s): Parameters of endothelial function and inflammator
y activity.
Result(s): During 12 months of follow-up, we observed decreases of 15% in p
lasma levels of endothelin-l, of 21% in soluble thrombomodulin, of 14% in v
on Willebrand factor, and of 12% in clottable fibrinogen in the hormone rep
lacement therapy group compared with the control group. There was a 5% decr
ease in soluble E-selectin levels. All significant changes were observed by
3 months and sustained after 15 months. Brachial artery flow-mediated vaso
dilatation and C-reactive protein levels did not change significantly.
Conclusion(s): Long-term combined hormone replacement therapy with E-2, and
dydrogesterone in healthy women was associated with sustained improvement
in some aspects of endothelial function and in clottable fibrinogen levels.
(Fertil Steril(R) 1999;71:663-70. (C)1999 by American Society for Reproduc
tive Medicine.).