Significant differential effects of lower doses of hormone therapy or tibolone on markers of cardiovascular disease in post-menopausal women: a randomized, double-blind, crossover study

Koh, Kwang Kon; Han, Seung Hwan; Shin, Mi-Seung; Ahn, Jeong Yeal; Lee, Yonghee; Shin, Eak Kyun

doi:10.1093/eurheartj/ehi311

Cited by 30 publications

(19 citation statements)

References 45 publications

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“…Meanwhile, tibolone does not affect fibrinogen like HT, but decreases PAI-1 antigen to a similar degree. In another study, when compared with CEE 0.3 mg combined with MP 100 mg [lower-dose (L)-HT], tibolone significantly reduces total cholesterol, triglyceride, HDL cholesterol levels, and triglyceride / HDL cholesterol ratios but not total cholesterol / HDL cholesterol ratios [69]. Tibolone improves flowmediated response to hyperemia from baseline values by a similar magnitude to L-HT.…”

Section: Tibolonementioning

confidence: 99%

Controversies regarding hormone therapy: Insights from inflammation and hemostasis

Koh

Yoon

2006

Cardiovascular Research

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Many observational studies and experimental and animal studies have demonstrated that estrogen therapy (ET) or hormone therapy (HT) significantly reduces the risk of coronary heart disease. Nonetheless, recent randomized controlled trials and the Nurses' Health Study in secondary prevention demonstrate trends toward an increased risk of cardiovascular events rather than a reduction of risk from HT. HT has both anti-inflammatory and pro-inflammatory effects, and it activates coagulation and improves fibrinolysis. These effects depend on the route of administration, doses of estrogen, age of women, and the presence of coronary artery disease or the coexistence of other risk factors for hypercoagulability. In this review, we discuss effects of HT on markers of inflammation, hemostasis, and fibrinolysis that may link endothelial dysfunction in cardiovascular diseases. We also briefly discuss effects of lower doses of HT and tibolone in postmenopausal women.

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Section: Tibolonementioning

confidence: 99%

Controversies regarding hormone therapy: Insights from inflammation and hemostasis

Koh

Yoon

2006

Cardiovascular Research

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“…In contrast, Mikkola et al (2002) reported that tibolone (0.2 mg/kg) induced a dose-dependent reduction in HDL levels up to 52%, a value not far from those found in the present study. Other reports also found a tibolone-related decrease in HDL serum levels (Bjarnason et al 1997;Koh et al 2005;Christodoulakos et al 2006).…”

Section: Discussionmentioning

confidence: 83%

Estradiol valerate and tibolone: effects upon brain oxidative stress and blood biochemistry during aging in female rats

et al. 2008

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Estrogen compounds have been described as important brain protectors. This study investigated the effects of estradiol valerate (EV--0.3 mg/kg) and two concentrations of tibolone (TB1=0.5 mg/kg and TB2=1 mg/kg) on brain oxidative stress parameters and blood biochemistry in ovariectomized female rats, of three different age groups (young--2 months, adult--8 months, and old--20 months). In the brain cortex, young and old TB2-treated and old no-hormone-replacement (NR) females showed lower lipid hydroperoxide (LPO) levels compared to young Sham and adult TB1 animals (P<0.05). Also in the cortex, both tibolone doses produced higher (P<0.05) total antioxidant capacity (TOSC) levels compared to EV-treated adult females. Ovariectomized adult females (NR, EV, TB1 and TB2) showed lower (P<0.05) TOSC levels in the hippocampus compared to the Sham control. Reactive oxygen species (ROS) were higher (P<0.05) in old females compared to all younger ones. TB2-treated adults showed higher plasma glucose (P<0.05) levels compared to old animals. Regardless of age, TB2 treatment increased female (P<0.05) LDL levels compared to Sham and EV-treated animals. In old females, TB2 significantly increased HDL levels compared to Sham controls, and decreased triglyceride levels were shown in EV, TB1 and TB2 compared to Sham old females. The Atherogenic Index of Plasma was higher (P<0.05) in adult tibolone-treated females compared to both young and old TB2-treated females. These results suggest that the effects of gonad steroid on brain and blood physiology change significantly with aging, and that evaluating hormonal treatment types and doses could be the key factor in the potential use of a specific hormone therapy.

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“…Furthermore, the coagulation effects of conjugated E were demonstrated to be dose dependent, and the variety of Es used may have had different potencies with regard to their effect on coagulation activity (23,24). In the current study, E and tibolone replacement shifted the hemostatic parameters to a more fibrinolytic state with respect to some parameters over 6 months, but the number of women evaluated was far too small for any meaningful conclusion with regard to the actual occurrence of such a clinical thromboembolic event.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of tibolone and estrogen therapy on hemostasis in surgical menopause: a randomized, double-blind, placebo-controlled study

Güven

Güven²,

Kirazlı

et al. 2007

Fertility and Sterility

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Significant differential effects of lower doses of hormone therapy or tibolone on markers of cardiovascular disease in post-menopausal women: a randomized, double-blind, crossover study

Abstract: Both tibolone and L-HT improved flow-mediated response by a similar magnitude and did not significantly increase high-sensitivity C-reactive protein. However, tibolone significantly reduced PAI-1, but increased F1+2 more than L-HT.

Cited by 30 publications

References 45 publications

Controversies regarding hormone therapy: Insights from inflammation and hemostasis

Controversies regarding hormone therapy: Insights from inflammation and hemostasis

Estradiol valerate and tibolone: effects upon brain oxidative stress and blood biochemistry during aging in female rats

Comparison of the effects of tibolone and estrogen therapy on hemostasis in surgical menopause: a randomized, double-blind, placebo-controlled study

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