Long-term effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity in healthy postmenopausal women

Fertil Steril. 1999 Apr;71(4):663-70. doi: 10.1016/s0015-0282(98)00513-5.

Abstract

Objective: To study the effects of combined hormone replacement therapy on markers of endothelial function and inflammatory activity.

Design: Prospective, randomized, controlled study.

Setting: Academic hospital.

Patient(s): Healthy postmenopausal women with an intact uterus.

Intervention(s): For the first 12 months, the hormone replacement therapy group (n = 14) received oral E2, 1 mg daily, sequentially combined with 5 or 10 mg of dydrogesterone. Thereafter, they received oral E2, 2 mg daily, sequentially combined with 10 mg of dydrogesterone. The control group (n = 13) received no treatment. Data were collected at baseline and at 3, 12, and 15 months.

Main outcome measure(s): Parameters of endothelial function and inflammatory activity.

Result(s): During 12 months of follow-up, we observed decreases of 15% in plasma levels of endothelin-l, of 21% in soluble thrombomodulin, of 14% in von Willebrand factor, and of 12% in clottable fibrinogen in the hormone replacement therapy group compared with the control group. There was a 5% decrease in soluble E-selectin tevels. All significant changes were observed by 3 months and sustained after 15 months. Brachial artery flow-mediated vasodilatation and C-reactive protein levels did not change significantly.

Conclusion(s): Long-term combined hormone replacement therapy with E2 and dydrogesterone in healthy women was associated with sustained improvement in some aspects of endothelial function and in clottable fibrinogen levels.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dydrogesterone / administration & dosage
  • E-Selectin / blood
  • Endothelin-1 / blood
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / physiology*
  • Estradiol / administration & dosage
  • Estrogen Replacement Therapy*
  • Female
  • Fibrinogen / metabolism
  • Humans
  • Inflammation / blood*
  • Middle Aged
  • Postmenopause*
  • Prospective Studies
  • Solubility
  • Thrombomodulin / blood
  • von Willebrand Factor / metabolism

Substances

  • E-Selectin
  • Endothelin-1
  • Thrombomodulin
  • von Willebrand Factor
  • Estradiol
  • Fibrinogen
  • Dydrogesterone