Effects of hormone replacement therapy on lipoprotein(a) and lipids in postmenopausal women.

Kim, Chee Jeong; Jang, Hak Chul; Cho, Dong Hee; Min, Yong Ki

doi:10.1161/01.atv.14.2.275

Cited by 115 publications

(45 citation statements)

References 48 publications

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“…45 Hormone replacement therapy has been shown to lower Lp(a) levels in postmenopausal women. 46,47 In the present study, the difference in Lp(a) levels between cases and controls found in women but not in men may perhaps be explained by the fact that women are usually older than men when they suffer their first myocardial infarction. 44 Because there was no significant age difference between men and women in the present study, the selection bias due to rejection of individuals with previous myocardial infarction is probably greater among men than women.…”

Section: Glader Et Al C Pneumoniae and Lp(a) For Cerebral Infarctionscontrasting

confidence: 47%

Chlamydia pneumoniae Antibodies and High Lipoprotein(a) Levels Do Not Predict Ischemic Cerebral Infarctions

Glader

Stegmayr

Boman

et al. 1999

Stroke

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Background and Purpose-An association between high lipoprotein(a) [Lp(a)] levels and positive Chlamydia pneumoniaeIgG titers in coronary artery disease has been described. The possibility of predicting ischemic stroke by measurements of plasma Lp(a) and C pneumoniae antibodies was investigated. Methods-This incident case-control study included 101 case subjects (cases) who had suffered ischemic cerebral infarctions and 201 matched control subjects (controls). The study population was nested within the Västerbotten Intervention Program or the WHO MONICA project. Plasma samples were measured for C pneumoniae-specific IgG and IgA antibodies and Lp(a). Results-A significantly higher mean Lp(a) level was found in female cases than in female controls. However, plasma Lp(a) was unable to predict ischemic cerebral infarctions in either women or men. The proportion of individuals with positive C pneumoniae-specific IgG or IgA titers did not differ between cases and controls. Antibody titers were unable to predict a future stroke. The proportion of individuals with a positive C pneumoniae IgG titer in combination with a high Lp(a) level did not differ significantly between cases and controls. Conclusions-These data suggest that there is no association between baseline plasma Lp(a) levels, presence of C pneumoniae antibodies, and future ischemic cerebral infarctions. Furthermore, no evidence of an interactive effect between high Lp(a) levels and C pneumoniae IgG titers was found. However, selection bias and a recent C pneumoniae epidemic may have influenced the results.

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Section: Glader Et Al C Pneumoniae and Lp(a) For Cerebral Infarctionscontrasting

confidence: 47%

Chlamydia pneumoniae Antibodies and High Lipoprotein(a) Levels Do Not Predict Ischemic Cerebral Infarctions

Glader

Stegmayr

Boman

et al. 1999

Stroke

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“…The previous study examining the effect of plasma Lp(a) was done in the absence of atherosclerosis, which seems to be an important contributor to the arterial thrombotic process. In addition, other studies have shown a decrease in Lp(a) with HRT 17,18 and a correlation of Lp(a) to the amount of atherosclerosis. 36 Neither of these was observed in this study.…”

Section: Coagulation Parametersmentioning

confidence: 89%

“…11 How HRT lowers coronary heart disease risk is unclear, but evidence exists that HRT has beneficial effects on plasma lipoprotein concentrations, [12][13][14] inhibits progression of atherosclerosis, 15 inhibits arterial wall accumulation of LDL, 16 and reduces plasma Lp(a) concentrations. 17,18 However, there is still concern about the effect of HRT on thrombotic events. This concern is sufficient to direct many physicians to stop HRT in women with a history of thrombotic disease.…”

mentioning

confidence: 99%

Oral Contraceptives and Hormone Replacement Therapy Do Not Increase the Incidence of Arterial Thrombosis in a Nonhuman Primate Model

Bellinger

Williams

Adams

et al. 1998

ATVB

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Abstract-Older oral contraceptive (OC) formulations containing high doses of potent synthetic estrogens and progestins are associated with increased risk of thrombosis. To examine the effects of current low-dose OC and hormone replacement therapy (HRT) regimens on arterial thrombosis, premenopausal and surgically postmenopausal cynomolgus monkeys were divided into four treatment groups. Premenopausal monkeys were given either no OCs or ethinyl estradiol and levonorgestrel as an OC at a dose equivalent to that currently given to women. Postmenopausal monkeys were given either no HRT or conjugated equine estrogens and medroxyprogesterone as an HRT at a dose equivalent to that currently given to women. The monkeys were fed an atherogenic diet containing these treatments for 27 to 30 months. At the end of this time, arterial thrombosis was evaluated with a standardized stenosis/injury procedure in the left carotid artery. Blood flow velocity was monitored for cyclic or permanent occlusive thrombosis. The current OC and HRT regimens did not increase the susceptibility of the artery wall to develop an occlusive thrombus following injury and stenosis. In fact, there was a reduction in the incidence of thrombosis in the OC animals compared with untreated controls. Increased amounts of atherosclerosis were associated with an increased incidence of occlusive arterial thrombosis. Several selected coagulation parameters [von Willebrand factor, protein C, lipoprotein(a), and platelet aggregation] did not appear to be associated with either the amount of atherosclerosis or incidence of arterial thrombosis.(Arterioscler Thromb Vasc Biol. 1998;18:92-99.)

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“…A more ideal approach would be prospective study of subjects before and after therapeutic interventions aimed at altering serum Lp(a) levels. Because Lp(a) levels are mainly determined genetically 56 and there is no effective means to reduce Lp(a) levels without simultaneously affecting the levels of other lipoproteins, [57][58][59][60] such an interventional study would be difficult to perform. We have studied only those volunteers approached and willing to consent to studies on the effects of risk factors on arterial physiology, and therefore some selection bias may be present.…”

Section: Limitationsmentioning

confidence: 99%

Effect of Lp(a) on the Early Functional and Structural Changes of Atherosclerosis

Raitakari

Adams

Celermajer

1999

ATVB

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Abstract-Epidemiologic studies have shown a significant relationship between elevated plasma levels of Lp(a) and increased risk of cardiovascular events; however, the mechanisms by which elevated Lp(a) levels produce this increased risk are not known. To test the hypothesis that high Lp(a) levels might contribute to the development of subclinical atherosclerosis, we examined the influence of Lp(a) levels on early functional and structural atherosclerotic vascular changes. Flow-mediated (endothelium-dependent) and nitrate-mediated (smooth muscle-dependent) arterial dilations were measured by high-resolution ultrasound in 241 normal healthy subjects (aged 15 to 69 years; 116 men). In addition, carotid artery intima-media thickness was measured by ultrasound in 71 subjects. Plasma Lp(a) was measured using a 2-sided immunoradiometric assay (cohort median, 10 mg/dL; interquartile range, 3.9 to 24.4 mg/dL). In these subjects, there were no significant relationships between Lp(a) 100 and has approximately 80% structural homology with plasminogen, a key protein of the coagulation cascade. 2 Most 3-7 but not all previous studies 8 -10 have shown that elevated Lp(a) is an independent risk factor for coronary heart disease. The exact mechanism by which Lp(a) confers cardiovascular risk is unknown; however, both proatherogenic and prothrombogenic effects have been hypothesized. 2,[11][12][13] The early stages of atherosclerosis are associated with changes in arterial function and structure that can now be studied noninvasively using high-resolution ultrasound. A key early event in atherosclerosis is endothelial dysfunction, 14,15 which can be detected in systemic conduit arteries by measuring flow-mediated dilation. 16 Subtle structural changes, such as thickening of the arterial intima-media complex, also occur early in the atherosclerotic disease process. 17,18 Many conventional risk factors, such as smoking, hypercholesterolemia, hypertension, and diabetes, have recently been shown to be significantly associated with impaired arterial endothelial function 19 and with increased arterial wall thickness, 20 -22 consistent with their accepted role in atherogenesis. Much less is known, however, about the effects of Lp(a) on these early markers of arterial disease in healthy asymptomatic subjects. The purpose of the present study was therefore to examine the effects of plasma Lp(a) levels on early functional and structural atherosclerotic vascular changes in a cohort of normal healthy subjects. Methods SubjectsWe studied 241 healthy subjects aged 40Ϯ15 years, (range, 15 to 69 years; 116 men, 125 women). None of these subjects had any history or clinical signs of coronary atherosclerosis, diabetes mellitus, familial hypercholesterolemia, or homozygous homocystinuria. All subjects were white. The subjects were recruited from hospital staff and volunteers from the community. None of the subjects was taking any regular cardioactive medications. There were 190 nonsmokers (79%), 40 current smokers (17%) and 11 ex-smokers (4%)....

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Effects of hormone replacement therapy on lipoprotein(a) and lipids in postmenopausal women.

Cited by 115 publications

References 48 publications

Chlamydia pneumoniae Antibodies and High Lipoprotein(a) Levels Do Not Predict Ischemic Cerebral Infarctions

Chlamydia pneumoniae Antibodies and High Lipoprotein(a) Levels Do Not Predict Ischemic Cerebral Infarctions

Oral Contraceptives and Hormone Replacement Therapy Do Not Increase the Incidence of Arterial Thrombosis in a Nonhuman Primate Model

Effect of Lp(a) on the Early Functional and Structural Changes of Atherosclerosis

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