Effect of postmenopausal hormone replacement on atherosclerosis in femoral arteries

Angerer, Peter; Störk, Stefan; Kothny, Wolfgang; Schacky, Clemens von

doi:10.1016/s0378-5122(01)00255-9

Cited by 25 publications

(13 citation statements)

References 38 publications

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“…[2][3][4] Randomized trials have provided variable results. Trials using conjugated estrogens with medroxyprogesterone acetate, 5 estradiol with gestodene, 6,7 and estradiol with norgestrel 8 found no effect on carotid or femoral artery intimamedia thickness. In contrast, unopposed estradiol did reduce progression of ultrasonographic carotid disease.…”

mentioning

confidence: 98%

Estrogen Plus Progestin and the Risk of Peripheral Arterial Disease

et al. 2004

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Background-Observational studies have reported less frequent carotid atherosclerosis in healthy women taking postmenopausal hormone therapy. Estrogen with progestin did not reduce peripheral arterial events among women with preexisting coronary heart disease. This analysis evaluates clinical peripheral arterial disease among generally healthy women in the Women's Health Initiative randomized trial of estrogen plus progestin. Methods and Results-The Estrogen Plus Progestin trial assigned 16 608 postmenopausal women, mean age 63.3Ϯ7.1 years, to daily conjugated estrogens (0.625 mg) with medroxyprogesterone acetate (2.5 mg) or placebo and documented health outcomes over an average of 5.6 years of follow-up. Hospitalization for peripheral arterial disease was infrequent, with annualized rates of 0.08%, 0.06%, and 0.02% for carotid disease, lower extremity arterial disease, and abdominal aortic aneurysm, respectively. The incidence of peripheral arterial events did not differ between treatment groups (hazard ratio [HR] 0.89, 95% confidence interval 0.63, 1.25). The risk was slightly greater among women assigned to active estrogen with progestin in years 1 (HR 1.33) and 2 (HR 1.27), and was slightly lower in later years (HR 0.85 and 0.87 in years 5 and Ն6). Among adherent participants, the hazard ratio for peripheral arterial events was 1.23 (95% confidence interval 0.79, 1.91) over the 5.6 years of follow up. Subgroup analysis identified no significant interactions between estrogen with progestin and baseline characteristics with regard to peripheral arterial disease risk. Conclusions-Among

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confidence: 98%

Estrogen Plus Progestin and the Risk of Peripheral Arterial Disease

et al. 2004

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“…Other changes seen in potentially protective surrogate markers of heart disease included either a decrease or no change in inflammatory markers, a decrease in endothelial markers 37 , a modest change in carbohydrate metabolism 31,40,42 , vasodilatation 29,30 , and a decrease in fibrinogen and factor VII activity 31, 33,36,37,43 . Antithrombin III and protein S activity were decreased in several studies 31,40 but plasminogen activity was increased and PAI-1 decreased 31 , perhaps leading to a neutral thrombotic effect.…”

Section: Discussionmentioning

confidence: 99%

“…Another study 27 showed no significant difference between low-dose HT and placebo on menopausal scores by the Kupperman Index, psychological well-being and quality of life. These [34][35][36][37][38][39][40] and total cholesterol 23,25,37-40 were seen with orally administered estradiol 1 mg and transdermal estradiol 0.025 mg 20 . The effects of estradiol 1 mg on triglycerides were variable and, as with CEE, some studies showed no change 23,34,36-39 , whilst others reported a significant increase 25, 35,40 .…”

Section: Effects Of Low-dose Ht On Menopausal Symptomsmentioning

confidence: 94%

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Effects of low-dose hormone therapy on menopausal symptoms, bone mineral density, endometrium, and the cardiovascular system: a review of randomized clinical trials

Peeyananjarassri

Baber

2005

Climacteric

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A change to low-dose HT has been advocated following adverse findings in recent trials of standard-dose HT. Although a literature review has shown low-dose HT to alleviate menopausal symptoms and maintain or improve bone density with fewer side-effects than standard-dose therapy, further research is required to determine what effect the lower-dose therapy will have on fracture, cardiovascular and breast disease.

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“…Hormone replacement has been associated with variable effects on IMT progression (257)(258)(259)(260).…”

Section: Clinical Trials With B Mode Ultrasound-defined Atherosclerosmentioning

confidence: 99%

Thematic review series: Patient-Oriented Research. Imaging atherosclerosis: state of the art

Crouse

2006

Journal of Lipid Research

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The ability to image obstructive arterial disease brought about a revolution in clinical cardiovascular care; the development of newer technologies that image arterial wall thicknesses, areas, volumes, and composition allows valid imaging of atherosclerosis for the first time. Development of noninvasive imaging of atherosclerosis has further led to a quantum shift in research in the field by enabling the study of asymptomatic populations and thus allowing investigators to focus on preclinical disease without the many biases associated with the study of symptomatic patients. These noninvasive investigations have broad implications for clinical care as well. Coronary angiography, computed tomographic (CT) imaging of coronary calcium, intravascular ultrasound, multidetector CT angiography, B mode ultrasound of the carotid arteries, and MRI of the carotid arteries all have unique strengths and weaknesses for imaging atherosclerosis. Certain of these techniques are extremely useful as outcome variables for clinical trials, and others are uniquely useful as predictors of the risk of cardiovascular disease. All are informative in one way or another with regard to the role of plaque remodeling and composition in disease causation. CT and MRI technology are advancing very rapidly, and research and clinical uses of these imaging modalities promise to further advance our understanding of atherosclerosis and its prevention.-Crouse, J. R., III. Imaging atherosclerosis: state of the art.

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Effect of postmenopausal hormone replacement on atherosclerosis in femoral arteries

Cited by 25 publications

References 38 publications

Estrogen Plus Progestin and the Risk of Peripheral Arterial Disease

Estrogen Plus Progestin and the Risk of Peripheral Arterial Disease

Effects of low-dose hormone therapy on menopausal symptoms, bone mineral density, endometrium, and the cardiovascular system: a review of randomized clinical trials

Thematic review series: Patient-Oriented Research. Imaging atherosclerosis: state of the art

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