Arterial imaging outcomes and cardiovascular risk factors in recently menopausal women: a randomized trial.
Ann Intern Med
; 161(4): 249-60, 2014 Aug 19.
Article
em En
| MEDLINE
| ID: mdl-25069991
ABSTRACT
BACKGROUND:
Whether menopausal hormone therapy (MHT) protects against cardiovascular disease (CVD) remains unclear.OBJECTIVE:
To assess atherosclerosis progression and CVD risk factors after MHT initiated in early menopause.DESIGN:
Randomized, controlled trial. (ClinicalTrials.gov NCT00154180).SETTING:
Nine U.S. academic centers.PARTICIPANTS:
Healthy menopausal women aged 42 to 58 years between 6 and 36 months from last menses without prior CVD events who had a coronary artery calcium (CAC) score less than 50 Agatston units and had not received estrogen or lipid-lowering therapy for at least 90 days. INTERVENTION Oral conjugated equine estrogens (o-CEE), 0.45 mg/d, or transdermal 17ß-estradiol (t-E2), 50 mcg/d, each with 200 mg of oral progesterone for 12 days per month, or placebo for 48 months. MEASUREMENTS Primary end point was annual change in carotid artery intima-media thickness (CIMT). Secondary end points included changes in markers of CVD risk.RESULTS:
Of 727 randomly assigned women, 89.3% had at least 1 follow-up CIMT and 79.8% had CIMT at 48 months. Mean CIMT increases of 0.007 mm/y were similar across groups. The percentages of participants in whom CAC score increased did not differ significantly across groups. No changes in blood pressure were observed with o-CEE or t-E2. Low- and high-density lipoprotein cholesterol levels improved and levels of C-reactive protein and sex hormone-binding globulin but not interleukin-6 increased with o-CEE. Insulin resistance decreased with t-E2. Serious adverse events did not differ by treatment.LIMITATION:
Power to compare clinical events was insufficient.CONCLUSION:
Four years of early MHT did not affect progression of atherosclerosis despite improving some markers of CVD risk. PRIMARY FUNDING SOURCE Aurora Foundation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Terapia de Reposição de Estrogênios
/
Pós-Menopausa
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Espessura Intima-Media Carotídea
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Etiology_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
/
Middle aged
Idioma:
En
Revista:
Ann Intern Med
Ano de publicação:
2014
Tipo de documento:
Article