The effects of oral and transdermal hormone replacement therapy on C-reactive protein levels and other inflammatory markers in women with high risk of thrombosis

Eilertsen, Anette Løken; Høibraaten, Else; Os, Ingrid; Andersen, Trine Opstad; Sandvik, Leiv; Sandset, Per Morten

doi:10.1016/j.maturitas.2005.01.004

Cited by 55 publications

(37 citation statements)

References 37 publications

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“…Although increased incidence of venous thrombosis has been reported in numerous clinical trials of estrogenic products in menopausal women (Scarabin et al, 1997;Herrington et al, 1998;Grodstein et al, 2001;Barrett-Connor et al, 2002;Rossouw et al, 2002;Vickers et al, 2007), little is known about what actually constitutes risk for an individual woman. Concentrations of soluble markers in the blood associated with either inflammation or proteins of the coagulation cascade including substances also associated with arterial disease such as C-reactive protein, fibrinogen, and homocysteine were higher in individuals who experienced a thrombotic event compared with those who did not (Meijers et al, 2000;Pradhan et al, 2002;van Hylckama Vlieg and Rosendaal, 2003;Eilertsen et al, 2005). Although assays for these plasma/ serum markers have been clinically validated, no global assessment tool has been established to identify an "at risk" phenotypic profile for an individual woman contemplating use of estrogenic treatments.…”

Section: E Thrombosismentioning

confidence: 96%

Vascular Actions of Estrogens: Functional Implications

2008

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Section: E Thrombosismentioning

confidence: 96%

Vascular Actions of Estrogens: Functional Implications

2008

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“…Some data exist on the effects of exogenous hormones on C-reactive protein (CRP), a marker of atherosclerosis known to be associated with increased risk of stroke in women. 3,14 Additionally, matrix metalloproteinases, a group of molecular biomarkers associated with blood-brain barrier disruption and hemorrhagic transformation with potential roles as prognostic indicators in stroke, have been shown to be down-regulated by estrogen. 12,15 However, it is unknown whether stroke biomarkers differ by sex or in pre-versus postmenopausal women or whether use of CRP or other biomarkers including matrix metalloproteinase could be incorporated into the diagnosis or prognosis of women presenting to the ED with stroke symptoms.…”

Section: Translational Research Strategiesmentioning

confidence: 99%

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Madsen

Seigel²,

Mackenzie

et al. 2014

Acad Emerg Med

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Cerebrovascular neurologic emergencies including ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are leading causes of death and disability that are frequently diagnosed and treated in the emergency department (ED). Although sex and gender differences in neurologic emergencies are beginning to become clearer, there are many unanswered questions about how emergency physicians should incorporate sex and gender into their research initiatives, patient evaluations, and overall management plans for these conditions. After evaluating the existing gaps in the literature, a core group of ED researchers developed a draft of future research priorities. Participants in the 2014 Academic Emergency Medicine consensus conference neurologic emergencies working group then discussed and approved the recommended research agenda using a standardized nominal group technique. Recommendations for future research on the role of sex and gender in the diagnosis, treatment, and outcomes pertinent to ED providers are described for each of three diagnoses: stroke, SAH, and migraine. Recommended future research also includes investigation of the biologic and pathophysiologic differences between men and women with neurologic emergencies as they pertain to ED diagnoses and treatments.ACADEMIC EMERGENCY MEDICINE 2014;21:1403-1413 by the Society for Academic Emergency Medicine C erebrovascular neurologic emergencies such as ischemic and hemorrhagic stroke, subarachnoid hemorrhage (SAH), and migraine are among the most lethal and disabling conditions presenting to the emergency department (ED). We have made great strides in understanding and treating these conditions, and our efforts have led to improved outcomes for these patients. Sex-and gender-based distinctions, however, are only recently becoming clearer, and much work is needed to explain the differences observed between men and women. After a focused review of the current literature on preclinical, clinical, and outcomes differences between women and men, and then the consensus process, we propose a research agenda in the areas of stroke, SAH, and headache/migraine. METHODSAfter evaluating the current literature, the authors, all emergency medicine (EM) researchers, proposed an agenda for future research. Consensus was reached using an iterative process through the four-part nominal group technique as already described in the executive summary. 1 A multidisciplinary group of participants (EM, critical care medicine, internal medicine, physical and rehabilitation medicine) prioritized the final iteration of themes/questions using the Poll Everywhere Web-based voting method. Descriptive statistics were calculated to tabulate the final list of questions presented below. The proposed research questions were then discussed and voted on by participants in the Academic Emergency Medicine consensus conference neurologic emergencies working group (see footnote for listing) at the meeting in May 2014. STROKE Epidemiology/OutcomesStroke is the fourth leading ca...

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“…94 Because the effect of hormone therapy on inflammatory markers is not uniform for all markers, and many markers, including tumor necrosis factor-␣ and cellular adhesion molecules, actually decrease with hormone therapy use, it remains likely that the increase in hs-CRP does not represent a generalized increase in systemic inflammation. 95 Despite the possible proinflammatory effects of hormone therapy noted in clinical studies, estrogen has been shown to have anti-inflammatory actions in premenopausal women, with a shift toward proinflammatory cytokine production through the menopausal transition. 96 Therefore, the responses of these cytokines and other inflammatory markers in the presence of estrogen depends on whether they have been tested in human, animal, or cell culture models, and which type of estrogen was studied.…”

Section: Potential Role Of Inflammatory Biomarkers Of Risk In Womenmentioning

confidence: 99%

Advancing the Study of Stroke in Women

Bushnell

Hurn

Colton

et al. 2006

Stroke

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Background and Purpose-Women have poorer outcomes from stroke than men. Women also have risk factors that are unique, including pregnancy and hormone therapy. Hormone therapy for postmenopausal replacement increased the risk of ischemic stroke according to results of the Women's Health Initiative clinical trials. Based on the current understanding of the mechanisms of action of estrogen, the reasons for this increased risk are uncertain. One method to better understand the reasons for this increased risk is to re-evaluate estrogen's role in the neurovascular unit, simplistically comprised of the neurons, glia, and endothelial cells, as well as the processes of inflammation, and hemostasis/thrombosis. Besides the role of estrogen there are many gaps of knowledge about issues specific to women and stroke. Summary of Review-A multidisciplinary workshop was held in August 2005 to summarize the current evidence for estrogen and, more generally, stroke in women, and to provide recommendations for future basic, preclinical, and clinical research studies. Conclusions-These studies may ultimately change the approach to stroke prevention and treatment in women. (Stroke.

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The effects of oral and transdermal hormone replacement therapy on C-reactive protein levels and other inflammatory markers in women with high risk of thrombosis

Cited by 55 publications

References 37 publications

Vascular Actions of Estrogens: Functional Implications

Vascular Actions of Estrogens: Functional Implications

Gender Differences in Neurologic Emergencies Part I: A Consensus Summary and Research Agenda on Cerebrovascular Disease

Advancing the Study of Stroke in Women

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