A randomized trial on effects of hormone therapy on ambulatory blood pressure and lipoprotein levels in women with coronary artery disease

Objective To investigate 1-year effects of hormone replacement therapy (HRT ) on ambulatory blood pressure (ABP) and lipoprotein levels in postmenopaus al women with coronary artery disease (CAD). Methods Sixty patients at a mean age (+/- SD) of 59 +/- 7 years were random ized into three groups: conjugated equine oestrogens (CEE) 0.625 ma daily ( n = 20), 50 mu g 17 beta-oestradiol transdermally (TTSE) per 24 h (n = 20) or placebo (n = 20) for 18 days, then combined with medroxyprogesterone ace tate 5 mg for 10 days. Each cycle of 28 days was repeated for one year. Results Night-time systolic ABP had decreased by 9.6% (P = 0.0075) in 15 of 18 women in the CEE group and by 22% in 12 of 13 women (P = 0.0034) in the placebo group after 1 year. In the CEE group, a 4.6% rise in daytime systo lic ABP (P < 0.05) and a 4.2% rise in night-time systolic ABP (P < 0.05) ap peared from baseline to 6 months in 13 of 18 women. In the CEE group (14 wo men analysed), high-density lipoprotein levels showed a 15.8% increase (P = 0.0018) in 13 women, low-density lipoprotein levels a 15.2% decrease (P = 0.0129) in 12 women and total cholesterol levels a 7.5% decrease (P = 0.057 ) in 11 women after 1 year. Triglyceride levels showed no changes. In the T TSE group and in the placebo group, with 12 and 13 women analysed respectiv ely, no significant changes appeared. Conclusions One year of HRT in patients with CAD does not influence ABP, Or al HRT induces beneficial effects on lipoprotein levels. J Hypertens 1999, 17:1379-1386 (C) Lippincott Williams & Wilkins.