Hormone Replacement Therapy in Postmenopausal Women and Its Effects on Plasma Lipid Levels

Abstract

Postmenopausal women run the same risks of coronary heart disease as men. The lipid alterations observed at this time reflect increased blood levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and lipoprotein (a), and reduced high-density lipoprotein cholesterol (HDL-C) levels. These changes lead to a higher risk of coronary artery disease, and hormonal therapy has a favorable effect on lipid metabolism. In this paper we review the literature on hormone replacement therapy (HRT) in postmenopausal women with the emphasis on the role of lipids in the pathogenesis of coronary heart disease, and on the action of estrogens and their correlation with progestogens, as well as routes of HRT administration. We conclude that the HRT changes the lipid profile in a potentially anti-atherogenic direction, usually reducing LDL-C and increasing HDL-C and triglycerides. Otherwise, for postmenopausal women with established coronary disease HRT is not recommended.

Complex Adaptive System Models and the Genetic Analysis of Plasma HDL-Cholesterol Concentration

“…This study suggests that hormonal and other cumulative environmental exposures (such as diet) impact HDL-C metabolism and RCT in a genotype-dependent manner. Consistent with this suggestion is the observation that elevated estrogen levels in premenopausal women and hormone replacement therapy in postmenopausal women are associated with increased plasma HDL-C concentration (Erberich et al 2002). These results reinforce the proposition that context-dependent effects on relationships between components of RCT metabolism may account for a large fraction of inter-individual variation in plasma HDL-C not explained by invariant gene and environmental effects.…”

The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes

“…This is augmented by the hepatic synthesis of VLDL, particularly of the large TG-rich particles, as well as the inhibition of hepatic triglyceride lipase [15,106]. Despite this HRT-associated elevation in TG levels, concomitant favorable effects of HRT administration include decreased LDL and TC, as well as elevated HDL levels [106].…”

Effekty dlitel'nogo primeneniya estrogen-gestagennoy terapii u zhenshchin reproduktivnogovozrasta s izolirovannym gipogonadotropnymgipogonadizmom

“…1). Эстрогены обладают прямым пролактин-стимулирующим действием [7], что обусловливает раз-ницу в содержании пролактина у мужчин и женщин ре-продуктивного возраста [2], это отразилось на содержании пролактина у пациенток, больных ги-поэстрогенией вследствие изолированного гипогона- О р и г и н а л ь н ы е р а б о т ы дотропного гипогонадизма и в нашем исследовании. На фоне проведения эстроген-гестагенной терапии со-держание пролактина у женщин группы 1 составило 263 (175; 311) мЕд/л.…”

“…Кроме того, эстро-гены оказывают прямое и опосредованное влияние на сердечно-сосудистую систему и участвуют в форми-ровании механизмов, обусловливающих в дальнейшем кардиоваскулярные риски. Негативное влияние гипоэ-строгении и возможные способы ее коррекции доста-точно изучены у женщин в период климактерия [4], при синдроме раннего истощения яичников [13], син-дроме Шерешевского-Тернера [7]. Однако женщинам репродуктивного возраста с гипогонадотропным гипо-гонадизмом посвящены единичные работы, и опыт применения эстроген-гестагенной терапии, описан-ный в литературе, не превышает 12 мес.…”