A cross-sectional study of the effects of hormon replacement therapy on the cardiovascular disease risk profile in healthy postmenopausal women

Objective: To assess risk factors for cardiovascular disease in healthy postmenopausal women who had been uninterruptedly on menopausal hormone replacement therapy (HRT) for at least 5 years or who had not received any HRT. Design: Cross-sectional study. Setting: The Royal Free Hospital and The Middlesex Hospital. Patient(s): A total of 256 healthy postmenopausal women were analyzed: 73 were taking tibolone, 60 were taking transdermal E-2, 58 were taking conjugated equine estrogens (E), and 65,were not taking any menopausal therapy. Intervention (s): Cardiovascular disease risk factors measurement. Main Outcome Measure(s): Total cholesterol. HDL cholesterol, LDL cholesterol. triglycerides. lipoprotein(a). insulin, glycated hemoglobin, high sensitivity C-reactive protein, fibrinogen, total antioxidants, and endothelin-1. Result(s): The different types of HRT induced disparate changes in the various markers of cardiovascular disease. Significantly higher high sensitivity C-reactive protein concentrations were found in women receiving conjugated equine E and tibolone than in women who were not taking any therapy. Glycated hemoglobin was significantly lower in women receiving transdermal E, and tibolone compared to women not on HRT. Women on tibolone had significantly higher systolic blood pressure. Conclusion(s): Because high sensitivity C-reactive protein has recently emerged as an important predictor of cardiovascular disease, the higher high sensitivity C-reactive protein levels observed in women on conjugated equine estrogens and on tibolone have potential important clinical implications. (Fertil Steril((R)) 2002 77: 945-51. (C)2002 by American Society for Reproductive Medicine).