Postmenopausal estrogen and progestin use and the risk of cardiovascular disease

Grodstein, Fran; Manson, JE; Colditz, Graham A.; Willett, Walter C.; Rosner, B; Fe, Speizer; Hennekens, C. H.

doi:10.1016/s0378-5122(97)88486-1

Cited by 149 publications

(187 citation statements)

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“…the lack of progestin in virtually all HRT users should be considered in the evaluation of cholesterol results, although oral progestins such as medroxyprogesterone acetate do not seem to attenuate the effects of oestrogen replacement therapy both on cardiovascular risk factors (The writing group for the PEPI trial. 1995) and events (Grodstein et al 1996(Grodstein et al . 1997.…”

Section: Discussionmentioning

confidence: 99%

Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial

et al. 1998

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Summary The combination of tamoxifen and transdermal hormone replacement therapy (HRT) may potentially reduce risks and side-effects of either agent, but an adverse interaction could attenuate their beneficial effects. We assessed the effects of their combination on cardiovascular risk factors within a prevention trial of tamoxifen. Baseline and 1 2-month measurements of total, low-density lipoprotein (LDL)-and high-density lipoprotein (HDL)-cholesterol, platelets and white blood cells were obtained in the following four groups: tamoxifen (n = 1117), placebo (n = 1112), tamoxifen and HRT (n = 68), placebo and HRT (n = 87). The analysis was further extended to women who were on HRT at randomization but discontinued it during the 12-month intervention period (n= 33 on tamoxifen and n = 35 on placebo) and to women who were not on HRT but started it during intervention (n = 36 in both arms of the study). Compared with small changes in the placebo group, tamoxifen was associated with changes in total, LDL-and HDL-cholesterol of approximately -90/, -19% and +0.2% in continuous HRT users compared with -9%/6, -14% and -0.8% in never HRT users. Similarly, there was no interaction on platelet count. In contrast, the decrease in total and LDL-cholesterol levels induced by tamoxifen was blunted by two-thirds in women who started HRT while on tamoxifen (P = 0.051 for the interaction term). We conclude that the beneficial effects of tamoxifen on cardiovascular risk factors are unchanged in current HRT users, whereas they may be attenuated in women who start transdermal HRT while on tamoxifen. Whereas a trial of tamoxifen in women already on transdermal HRT is warranted, prescription of HRT during tamoxifen may attenuate its activity.

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Section: Discussionmentioning

confidence: 99%

Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial

et al. 1998

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“…Before 2002, HRT had been regarded as an intervention with great potential benefits in terms of cardiovascular disease prevention and osteoporosis treatment [1][2][3]. The publications of the Women Health Initiative (WHI) trial results [4][5][6] and the results of the observational Million Women Study (MWS) [7] reported increased rates of breast cancer, coronary heart diseases, stroke, dementia and venous thromboembolism and decreased rates of hip fractures and colorectal cancer in postmenopausal women using long-term HRT.…”

Section: Introductionmentioning

confidence: 99%

HRT use in 2001 and 2004 in The Netherlands—A world of difference

2006

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“…1 However, the potentially beneficial effects of HRT in reducing coronary heart disease (CHD) risk would suggest a role for it in the management of hypertension. 2,3 The loss of oestrogen at the menopause appears to be associated with an overall rise in blood pressure. 4 Little information is available regarding the long-term effects of HRT in hypertensive women, but short duration studies in hypertensive women have demonstrated either a neutral or even modest hypotensive effect.…”

Section: Introductionmentioning

confidence: 99%

A randomised placebo controlled trial of the effects of tibolone on blood pressure and lipids in hypertensive women

et al. 2000

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The effects of hormone replacement therapy in hypertensive women are controversial. This randomised placebo controlled trial assessed the effect of tibolone 2.5 mg on blood pressure and fasting plasma lipids in 29 hypertensive postmenopausal women over 6 months using a 2:1 randomisation to tibolone. The primary clinical end-point was mean office blood pressure. At 6 months systolic blood pressure declined by 5.30 ؎ 2.87% vs 4.94 ؎ 3.37% whilst diastolic blood pressure declined 5.38 ؎ 2.65% vs 0.85 ؎ 3.69% on tibolone and placebo respectively. These differences were not statistically significant. Triglycerides decreased by 33.3 ؎ 6.1% vs 7.6 ؎ 7.9% (P Ͻ 0.01) and

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Postmenopausal estrogen and progestin use and the risk of cardiovascular disease

Cited by 149 publications

References 0 publications

Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial

Effect of tamoxifen and transdermal hormone replacement therapy on cardiovascular risk factors in a prevention trial

HRT use in 2001 and 2004 in The Netherlands—A world of difference

A randomised placebo controlled trial of the effects of tibolone on blood pressure and lipids in hypertensive women

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