Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Jul;205(1):325-30.
doi: 10.1016/j.atherosclerosis.2008.12.020. Epub 2008 Dec 24.

Changes in remnant and high-density lipoproteins associated with hormone therapy and progression of coronary artery disease in postmenopausal women

Stefania Lamon-Fava  1 , David M Herrington, David M Reboussin, Michelle Sherman, Katalin Horvath, Ernst J Schaefer, Bela F Asztalos
Affiliations
Randomized Controlled Trial

Changes in remnant and high-density lipoproteins associated with hormone therapy and progression of coronary artery disease in postmenopausal women

Stefania Lamon-Fava et al. Atherosclerosis. 2009 Jul.

Abstract

Objective: This study examined the effect of hormone therapy (HT) on the plasma concentration of remnant lipoprotein cholesterol (RLP-C) and high-density lipoprotein (HDL) subpopulations and the contribution of HT-related changes in these lipoproteins to the progression of coronary heart disease (CHD) in postmenopausal women.

Methods: Study participants were 256 women who completed the Estrogen Replacement and Atherosclerosis (ERA) trial, a placebo-controlled, randomized trial that examined the effects of 3.2 years of conjugated equine estrogen (CEE, 0.625 mg/day) or CEE (0.625 mg/day) plus medroxyprogesterone acetate (MPA, 2.5mg/day) on postmenopausal women with established coronary atherosclerosis. Quantitative coronary angiography and plasma RLP-C and HDL subpopulations were assessed at baseline and at follow-up.

Results: Relative to placebo, both CEE and CEE+MPA caused a significant reduction in plasma RLP-C concentrations and a significant increase in alpha1 and alpha2 HDL subpopulations. However, in the HT-treated subjects, faster progression of coronary atherosclerosis was observed in women who experienced the greatest reductions in RLP-C and in prebeta1 HDL subpopulations.

Conclusions: Our data suggest that individual variability in RLP-C and HDL subpopulation response to HT is a predictor of CHD progression. Lipoprotein response to HT may be an indirect marker of susceptibility to other harmful effect of HT in postmenopausal women with established CHD or an indication of formation of dysfunctional lipoproteins.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors do not have conflicts of interest related to the work reported in this manuscript.

Figures

Figure 1
Figure 1
Changes in plasma TG (panel A), apo C-III (panel B), and RLP-C (panel C) concentrations in the placebo (white), estrogen (light gray), and estrogen plus progestin (dark gray) arms of the ERA study; * P<0.001, relative to changes in the placebo arm. Data expressed as mean change±SE.
Figure 2
Figure 2
Changes in plasma HDL-C, apo A-I, and HDL subpopulations in the placebo (upper panel), estrogen (middle panel), and estrogen + progestin (lower panel) arms of the ERA trial. HDL subpopulations are expressed as mg/dL of plasma apo A-I. * P<0.001, relative to changes in the placebo arm. Data expressed as mean change±SE.
Figure 3
Figure 3
Mean changes in mean minimum coronary artery diameter by tertiles of changes in plasma RLP-C levels (P<0.016) in women randomized to HT (N=152).
See this image and copyright information in PMC

References

    1. Hulley SB, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA. 1998;280:605–613. - PubMed
    1. Herrington DM, Reboussin DM, Brosnihan B, et al. Effects of estrogen replacement on the progression of coronary-artery atherosclerosis. New England Journal of Medicine. 2000;343:522–529. - PubMed
    1. Clarke S, Kelleher J, Lloyd-Jones H, et al. A study of hormone replacement therapy in postmenopausal women with ischemic heart disease: the Papworth HRT atherosclerosis study. British Journal of Obstetrics and Gynecology. 2002;109:1056–1062. - PubMed
    1. Angerer P, Stork S, Kothny W, et al. Effects of oral postmenopausal hormone replacement on progression of atherosclerosis. A randomized, controlled trial. Arteriosclerosis, Thrombosis & Vascular Biology. 2001;21:262–268. - PubMed
    1. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–333. - PubMed

Publication types