Effects of raloxifene and hormone replacement therapy on markers of serum atherogenicity in healthy postmenopausal women

Objective: To determine the effect of raloxifene (RLX) and hormone replacem ent therapy HRT) on non-high density lipoprotein cholesterol (non-HDL-C) le vels and the apolipoprotein-B/apolipoprotein-Al (apo-B/apo-Al) concentratio n ratio, markers of serum atherogenicity, in postmenopausal women. Methods: Three hundred and ninety healthy postmenopausal women aged 45-72 years wer e enrolled in a double-blind, randomized, placebo -controlled, parallel tri al at eight outpatient sites in the United States. Women were randomly assi gned to receive continuous combined HRT (0.625 mg/day conjugated equine est rogen and 2.5 mg/day medroxyprogesterone acetate), 60 or 120 mg/day raloxif ene, or placebo for 6 months. Serum concentrations of non-HDL cholesterol a nd the apo-B/apo-Al concentration ratio were measured in serum samples obta ined at baseline and at 6 months of treatment. Results: At 6 months, non-HD L-C and apo-B/apo-Al were significantly reduced by 60 mg/day RLX (10 and 11 %, respectively), 120 mg/day RLX (9 and 12%, respectively) and HRT (10 and 12%, respectively), compared with placebo. The effect of all treatments to lower non-HDL-C and apo-B/apo-Al was greatest in women with hypercholester olemia (total-C > 240 mg/dl) at baseline. Among women with undesirable ( > 160 mg/dl) non-HDL cholesterol at baseline, RLX and HRT lowered the percent age of these women remaining above this threshold after 6 months (placebo, 89%; 60 mg/day RLX, 61%; 120 mg/day RLX, 74%; HRT, 58%). Similar results we re observed for women with high (> 190 mg/dl) non-HDL cholesterol at baseli ne. Conclusion: In healthy postmenopausal women, RLX and HRT lower serum no n-HDL-C and apo-B/apo-Al, indicators of serum atherogenicity, to a similar extent. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.