Hormone replacement therapy: Benefit and safety issues

Current Opinion in Lipidology

Volumn 7, Issue 6, 1996, Pages 369-373

  Denke, Margo A ^a  

^a UNIVERSITY OF TEXAS AT DALLAS   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTILIPEMIC AGENT; ESTRADIOL; ESTROGEN; GESTAGEN; HIGH DENSITY LIPOPROTEIN; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LIPOPROTEIN; LOW DENSITY LIPOPROTEIN; LOW DENSITY LIPOPROTEIN CHOLESTEROL; MEDROXYPROGESTERONE;

ADULT; AGED; ARTERY DILATATION; BREAST CANCER; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG OXIDATION; ENDOMETRIUM CANCER; FEMALE; HEART PROTECTION; HORMONE SUBSTITUTION; HUMAN; HYPERTENSION; HYPERTRIGLYCERIDEMIA; LIPID BLOOD LEVEL; LIPOPROTEIN BLOOD LEVEL; MAJOR CLINICAL STUDY; META ANALYSIS; ORAL DRUG ADMINISTRATION; OSTEOPOROSIS; POSTMENOPAUSE; PRIORITY JOURNAL; RISK BENEFIT ANALYSIS; SHORT SURVEY; THROMBOSIS; TRANSDERMAL DRUG ADMINISTRATION;

EID: 0030508512     PISSN: 09579672     EISSN: None     Source Type: Journal    
DOI: 10.1097/00041433-199612000-00005     Document Type: Short Survey

References (37)

1. Barrett-Conner E: Postmenopausal estrogen and heart disease. Atherosclerosis 1995, 118 (suppl):S7-S10. A brief review of the observed benefits and risks of HRT. The review summarizes the author's interpretation of the available data and concludes with a logical clinical approach to the management of patients.
2. Lip GYH, Beevers G, Zarifis J: Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint. J Intern Med 1995, 238:389-399. A comprehensive review of the clinical issues regarding HRT. A flow chart is included for physicians who want a treatment nomogram.
3. Samaan SA, Crawford MH: Estrogen and cardiovascular function after menopause. J Am Coll Cardiol 1995, 26:1403-1410. A review of specific effects, in animals and humans, of estrogens and progestogens on cardiovascular function, including hemodynamic effects and effects on exercise performance.
4. Rackley CE: Estrogen and coronary artery disease in postmenopausal women. Am J Med 1995, 99:117-118.
5. Frankel D: Postmenopausal oestrogen replacement affords cardioprotection. Obstet Gynecol 1996, 87:6-12. Relative risk of all-cause mortality was 0.54 in 232 users of HRT compared with nonusers (95% confidence interval 0.38-0.76). A trend towards higher risk for breast cancer was observed in the HRT group, but this did not achieve statistical significance (relative risk 1.89; 95% confidence interval 0.43-8.36).
6. Prentice RL, Thomas DB: On the epidemiology of oral contraceptives and disease. Adv Cancer Res 1987, 49:285-401.
7. Centers for Disease Control: Long-term oral contraceptive use and the risk of breast cancer. JAMA 1983, 249:1591-1595.
8. Steinberg KK, Thacker SB, Smith SJ, Stroup DF, Zack MM, Flanders WD, Berkelman RL: A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA 1991, 265:1985-1990.
9. DiSaia PJ: Hormone-replacement therapy in patients with breast cancer: a reappraisal. Cancer 1993, 71:1490-1500.
10. The Writing Group for the PEPI trial: Effects of hormone replacement therapy on endometrial histology in postmenopausal women: the postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA 1996, 275:370-375. This is a landmark study - the first to document in a randomized, placebo-controlled trial the deleterious effects of unopposed estrogens on endometrial hyperplasia.
11. Croft P, Hannaford PC: Risk factors for acute myocardial infarction in women: evidence from the Royal College of General Practitioners' oral contraceptive study. Br Med J 1989, 298:165-168.
12. Mann JI: Progestogens in cardiovascular disease: an introduction to the epidemiologic data. Am J Obstet Gynecol 1982, 142:752-757.
13. The Coronary Drug Project Research Group: The Coronary Drug Project: Findings leading to discontinuation of the 2.5 mg per day estrogen group. JAMA 1973, 226:652-657.
14. Buring JE: Low dose oral contraceptives and stroke. N Engl J Med 1996, 335:53-54.
15. Petitti DB, Sidney S, Bernstein A, Wolf S, Quesenberry C, Ziel HK: Stroke in users of low-dose oral contraceptives. N Engl J Med 1996, 335:8-15.
16. Salomaa V, Rasi V, Pekkanen J, Vahtera E, Jauhiainen M, Vartiainen E, Ehnholm C, Tuomilehto J, Myllyla G: Association of hormone replacement therapy with hemostatic and other cardiovascular risk factors: The FINRISK hemostasis study. Arterioscler Thromb Vasc Biol 1995, 15:1549-1555.
17. Stefanick ML, Legault C, Tracy RP, Howard G, Kessler CM, Lucas DL, Bush TL: Distribution and correlates of plasma fibrinogen in middle-aged women - initial findings of the postmenopausal estrogen progestin interventions (PEPI) study. Arterioscler Thromb Vasc Biol 1995, 15:2085-2093. Significant correlates between fibrinogen level and known risk factors for coronary disease were observed. The report includes the specific fibrinogen values for each associated factor, allowing the reader to assess the magnitude of each effect.
18. The Writing Group for the PEPI trial: Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA 1995, 273:199-208. This landmark study documents the effects of four different HRT regimens compared with placebo on lipid and lipoprotein levels, systolic blood pressure, serum insulin and fibrinogen in 875 women.
19. Walsh BW, Schiff I, Rosner B, Greenberg L, Ravnikar V, Sacks FM: Effects of postmenopausal estrogen replacement on the concentration and metabolism of plasma lipoproteins. N Engl J Med 1991, 325:1196-1204.
20. Denke MA: Effects of continuous combined hormone replacement therapy on lipid levels in hypercholesterolemic postmenopausal women. Am J Med 1995, 99:29-35. HRT in women who are not experiencing menopausal symptoms has initially distressing side effects. The physician should be aware of symptoms and educate the patient that these symptoms lessen over time. Continuous combined HRT is effective in reducing LDL-cholesterol levels without lowering HDL-cholesterol levels.
21. Dallongeville J, Marecaux N, Isorez D, Zylberberg G, Fruchart JC, Amouyel P: Multiple coronary heart disease risk factors are associated with menopause and influenced by substitutive hormonal therapy in a cohort of French women. Atherosclerosis 1995, 118:123-133.
22. National Cholesterol Education Program: Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation 1994, 89:1329-1445.
23. Tonstad S, Ose L, Gorbitz C, Djoseland O, Bard JM, Fruchart JC: Efficacy of sequential hormone replacement therapy in the treatment of hypercholesterolaemia among postmenopausal women. J Intern Med 1995, 238:39-47. Cyclic use of HRT doses of 17-beta estradiol and norgestimate is effective in reducing LDL; as suspected, no increases in HDL-cholesterol levels were observed.
24. 131 in six women on standard continuous combined HRT with conjugated equine estrogens and medroxyprogesterone found reductions in LDL-cholesterol content and increase in the fractional catabolic rate of apoB without a reduction in apoB pool size.
25. Wolfe BM, Huff MW: Effects of combined estrogen and progestin administration on plasma lipoprotein metabolism in postmenopausal women. J Clin Invest 1989, 83:40-45.
26. Haines CJ, Chung TKH, Mesarei JRL, Tomlinson B, Lau JTF: An examination of the effect of combined cyclical hormone replacement therapy on lipoprotein(a) and other lipoproteins. Atherosclerosis 1996, 119:214-222.
27. Sacks FM, Walsh BW: The effects of reproductive hormones on serum lipoproteins: unresolved issues in biology and clinical practice. Ann N Y Acad Sci 1990, 592:272-285.
28. Taskinen MR: Postmenopausal hormone replacement therapy and plasma lipoproteins. J Intern Med 1995, 238:385-387.
29. Siseles NO, Halperin H, Benencia HJ, Berg G, Pilnnik S, Mesch V, Arrighi B, Wikinski RWW: A comparative study of two hormone replacement therapy regimens on safety and efficacy variables. Maturitas 1995, 21:201-210.
30. Villecco AS, DeAloysio D, Foderaro S, DiCamillo T, Iervese T, DiCamillo G: Comparison of the effects of simvastatin versus hormone replacement therapy in the treatment of postmenopausal women with primary hypercholesterolemia. Arterioscler Thromb Vasc Biol 1995, 56:515-529.
31. Guetta V, Panza JA, Waclawiw MA, Cannon RO: Effect of combined 17 beta-estradiol and vitamin E on low-density lipoprotein oxidation in postmenopausal women. Am J Cardiol 1995, 75:1274-1276.
32. Volterrani M, Rosano G, Coats A, Beale C, Collins P: Estrogen acutely increases peripheral blood flow in postmenopausal women. Am J Med 1995, 99:119-122.
33. Riedel M, Oeltermann A, Mügge A, Creutzig A, Rafflenbeul W, Lichtlen P: Vascular responses to 17 beta-oestradiol in postmenopausal women. Eur J Clin Invest 1995, 25:44-47.
34. Collin P, Rosano GMC, Sarrel PM, Ulrich L, Adamopoulos S, Beale CM, McNeill JG, Poole-Wilson PA: 17 beta-estradiol attenuates acetylcholine-induced coronary arterial constriction in women but not men with coronary heart disease. Circulation 1995, 92-.24-30. An intriguing study; why a gender difference was observed is unclear and needs further study.
35. Gerhard M, Ganz P: How do we explain the clinical benefits of estrogen? From bedside to bench. Circulation 1995, 92:5-8.
36. Salamone LM, Pressman AR, Seeley DG, Cauley JA: Estrogen replacement therapy: A survey of older women's attitudes. Arch Intern Med 1996, 156:1293-1297. Forty-five percent of past users of estrogen therapy had bleeding and 26% had breast discomfort as side effects; 30% discontinued estrogens because 'I felt I didn't need it'. This survey sheds light on important considerations for compliance - we need to be better educators.
37. Stumpf PG, Trolice MP: Compliance problems with hormone replacement therapy. Obstet Gyn Clin North Am 1994, 21:219-229.