Randomized trial of effects of continuous combined HRT on markers of lipids and coagulation in women with acute coronary syndromes: WHISP Pilot Study
- PMID: 16899475
- DOI: 10.1093/eurheartj/ehl183
Randomized trial of effects of continuous combined HRT on markers of lipids and coagulation in women with acute coronary syndromes: WHISP Pilot Study
Abstract
Aims: Randomized trials have not demonstrated coronary heart disease benefit from hormone replacement therapy (HRT). We hypothesized that low-dose HRT may avoid harm.
Methods and results: We studied the effects of HRT on lipids and coagulation in women with acute coronary syndromes. A total of 100 post-menopausal women >55 years were enrolled between 2 and 28 days after an acute coronary syndrome and randomized to oral oestradiol-17beta 1 mg plus norethisterone acetate 0.5 mg daily, or matching placebo, and followed for up to 12 months. Levels of lipids, lipoproteins, and haemostasis markers were measured at baseline, 3, and 6 months. There were no significant differences in lipid levels between the two groups, probably due to concomitant statin use. Antithrombin and factor VII levels were significantly lower in the HRT group, whereas fibrinogen was significantly decreased in the placebo group. No evidence of increased coagulation activation was observed, nor of adverse cardiovascular outcomes [odds ratio (OR) 0.63 (95% confidence intervals 0.31-1.31)].
Conclusion: Low-dose HRT may give cardiovascular benefit. These findings require confirmation in a full clinical trial with evaluation of cardiovascular outcomes as the primary objective.
Similar articles
-
The effects of hormone replacement therapy (HRT) on hemostatic variables in women with previous venous thromboembolism--results from a randomized, double-blind, clinical trial.Thromb Haemost. 2001 May;85(5):775-81. Thromb Haemost. 2001. PMID: 11372667 Clinical Trial.
-
The effect of various menopausal hormone therapies on markers of inflammation, coagulation, fibrinolysis, lipids, and lipoproteins in healthy postmenopausal women.Menopause. 2006 Jul-Aug;13(4):643-50. doi: 10.1097/01.gme.0000198485.70703.7a. Menopause. 2006. PMID: 16837886 Clinical Trial.
-
Lipids and clotting factors during low dose transdermal estradiol/norethisterone use.Maturitas. 2005 Apr 11;50(4):344-52. doi: 10.1016/j.maturitas.2004.10.001. Maturitas. 2005. PMID: 15780536 Clinical Trial.
-
Rationale for low-dose systemic hormone replacement therapy and review of estradiol 0.5 mg/NETA 0.1 mg.Adv Ther. 2008 Jun;25(6):525-51. doi: 10.1007/s12325-008-0070-6. Adv Ther. 2008. PMID: 18568306 Review.
-
HRT and the primary prevention of cardiovascular disease.Maturitas. 2007 May 20;57(1):31-4. doi: 10.1016/j.maturitas.2007.02.007. Epub 2007 Mar 26. Maturitas. 2007. PMID: 17383835 Review.
Cited by
-
Timing and duration of menopausal hormone treatment may affect cardiovascular outcomes.Am J Med. 2011 Mar;124(3):199-205. doi: 10.1016/j.amjmed.2010.09.021. Am J Med. 2011. PMID: 21396500 Free PMC article. Review.
-
The benefits and risks of menopause hormone therapy for the cardiovascular system in postmenopausal women: a systematic review and meta-analysis.BMC Womens Health. 2024 Jan 23;24(1):60. doi: 10.1186/s12905-023-02788-0. BMC Womens Health. 2024. PMID: 38263123 Free PMC article.
-
A systematic review and meta-analysis of effects of menopausal hormone therapy on cardiovascular diseases.Sci Rep. 2020 Nov 26;10(1):20631. doi: 10.1038/s41598-020-77534-9. Sci Rep. 2020. PMID: 33244065 Free PMC article.
-
A systematic review and meta-regression analysis to examine the 'timing hypothesis' of hormone replacement therapy on mortality, coronary heart disease, and stroke.Int J Cardiol Heart Vasc. 2019 Jan 18;22:123-131. doi: 10.1016/j.ijcha.2019.01.001. eCollection 2019 Mar. Int J Cardiol Heart Vasc. 2019. PMID: 30705938 Free PMC article.
-
Hormone therapy for preventing cardiovascular disease in post-menopausal women.Cochrane Database Syst Rev. 2015 Mar 10;2015(3):CD002229. doi: 10.1002/14651858.CD002229.pub4. Cochrane Database Syst Rev. 2015. PMID: 25754617 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical