The effect of raloxifene supplementation on blood pressure and Apo-lipoproteins in postmenopausal women: A systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Several studies indicated the ameliorating effects of raloxifene supplementation on apolipoproteins and blood pressure, although others have conflicting findings. Therefore, the present study was conducted in order to accurately and definitively understands the effect of raloxifene on apolipoprotein AI (Apo-AI), apolipoprotein B (APoB), lipoprotein (a) (Lp (a)), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in postmenopausal women. METHODS: A systematic literature search was conducted using scientific databases including PubMed, Scopus, Embase, and Web of Science and the Cochrane Library, through May 2024. The quality of studies was assessed using Cochrane tool. Random-effects meta-analysis was used to pool standardized mean differences (SMD) and 95 % CI for the outcomes. RESULTS: Twenty trials, with interventions ranging from 6 to 144 weeks and 2825 participants, were included. Raloxifene supplementation demonstrated significant reductions in ApoB (SMD -0.92; 95 % CI -1.49 to -0.35; P = 0.001), and Lp (a) (SMD -0.25; 95 % CI -0.39 to -0.11; P < 0.001) while increasing Apo-AI levels (SMD 0.29; 95 % CI 0.22-0.36; P < 0.001). Conversely, no significant effects were observed on SBP (WMD -0.49 mmHg; 95 % CI -3.01-2.04; P = 0.706), and DBP (WMD -0.81 mmHg; 95 % CI -4.04-2.41; P = 0.621). Moreover, subgroup analysis indicated that raloxifene significantly decreased DBP in studies with intervention durations of >12 weeks. CONCLUSIONS: This meta-analysis has shown that raloxifene supplementation may have beneficial effects on apolipoproteins in postmenopausal women. Future studies are needed to investigate the effect of raloxifene on health status in in postmenopausal women.