A randomised placebo controlled trial of the effects of tibolone on blood pressure and lipids in hypertensive women

The effects of hormone replacement therapy in hypertensive women are contro versial. This randomised placebo controlled trial assessed the effect of ti bolone 2.5 mg on blood pressure and fasting plasma lipids in 29 hypertensiv e postmenopausal women over 6 months using a 2:1 randomisation to tibolone. The primary clinical end-point was mean office blood pressure. At 6 months systolic blood pressure declined by 5.30 +/- 2.87% vs 4.94 +/- 3.37% whils t diastolic blood pressure declined 5.38 +/- 2.65% vs 0.85 +/- 3.69% on tib olone and placebo respectively, These differences were not statistically si gnificant, Triglycerides decreased by 33.3 +/- 6.1% vs 7.6 +/- 7.9% (P < 0. 01) and high-density lipoprotein (HDL)-cholesterol by 21.7 +/- 3.8% vs 2.4 +/- 2.6% (P < 0.01) with tibolone as opposed to placebo. No significant dif ferences were observed in total cholesterol, low-density lipoprotein (LDL)- cholesterol and lipoprotein (a). Fibrinogen levels were reduced by 13.6 +/- 6.8% on tibolone compared to a 19.3 +/- 15.4% rise (P < 0.05) on placebo. This study suggests that tibolone has no deleterious effect on blood pressu re in women with hypertension but has contrasting effects on biochemical ri sk factors. Largescale studies are required to determine the overall effect of tibolone on cardiovascular morbidity and mortality.