EFFECTS OF HORMONE REPLACEMENT THERAPY ON CARDIOVASCULAR RISK-FACTORSIN POSTMENOPAUSAL WOMEN

Objective: To investigate changes in plasma lipoprotein profile, hemos tatic factors, platelet aggregation, endothelin-1, and cardiac functio n during postmenopausal sequential 6-month hormone replacement therapy (HRT). Design: Open longitudinal prospective study. Setting: Gynecolo gic department of a medical center. Patient(s): Twenty-one healthy non hysterectomized postmenopausal women. Intervention(s): Oral E-2 valera te (2 mg/d) combined with medroxyprogesterone acetate (MPA) (10 mg/d) during the last 10 days of each 21-day cycle. The treatment period was 6 months. Main Outcome Measure(s): Plasma lipoprotein profile, hemost atic parameters, platelet aggregation, endothelin-1, and left ventricu lar function. Result(s): After 6 months of treatment, total cholestero l, triglyceride, and low-density lipoprotein (LDL) cholesterol were si gnificantly progressively reduced. Atherogenic indices of total choles terol-to-high-density Lipoprotein (HDL) cholesterol and LDL-to-HDL cho lesterols also showed a significant progressive decline. The concentra tions of antithrombin III were significantly increased. The maximum ag gregation and slope of platelet aggregation were significantly reduced , but all parameters were more pronounced at 1 month of HRT than at 3 or 6 months. The concentrations of endothelin-1 were significantly red uced (by 16.1%). In the evaluation of left ventricular function, only peak atrial diastolic velocity was significantly reduced. Conclusion(s ): Combined HRT had favorable effects on lipids and lipoproteins, hemo static factors, platelet aggregation, endothelin-1, and left ventricul ar function. However, further study is needed to evaluate the long-ter m effects of combined HRT, especially on platelet aggregation and card iac function. (C) 1998 by American Society for Reproductive Medicine.