Hormone replacement therapy and circulating ICAM-1 in postmenopausal women- A randomised controlled trial

Hormone replacement therapy may reduce the risk of coronary heart disease b ut underlying mechanism has not been adequately explained. Recent data sugg est that intercellular adhesion molecule 1 (ICAM-1) plays a critical role i n early stage of atherosclerosis and may serve as a molecular marker for th e development of arterial disease. We investigated the effects of oral and transdermal cyclic oestradiol combined with progesterone on plasma concentr ation of soluble ICAM-1 (sICAM-1). Thirty-seven healthy postmenopausal wome n were randomly assigned to receive either oral estradiol valerate or trans dermal estradiol both combined with micronized progesterone or no hormonal treatment. Plasma sICAM-1 was assayed at baseline and after a 6-month perio d. Oral but not transdermal estradiol regimen significantly decreased mean value of sICAM-1 compared with no treatment. Differences in sICAM-1 levels between active treatments were significant. There were no significant chang es in mean values of fibrinogen between the three groups. Our results show a favorable effect of oral estrogen plus progesterone on a soluble marker o f vascular inflammation and may provide plausible explanation for a cardiop rotective effect of hormone replacement therapy among healthy postmenopausa l women.