Effects of estrogen or estrogen progestin regimens on heart disease risk factors in postmenopausal women: the Postmenopausal Estrogen Progestin Interventions (PEPI) Trial

Article Abstract:

Estrogen or estrogen combined with a progestin may reduce some risk factors for heart disease in postmenopausal women. During a three-year period, researchers studied 875 postmenopausal women between the ages of 45 and 64 to evaluate the effects of hormone replacement therapy (HRT) on risk factors for heart disease. One group of women received a daily dose of conjugated equine estrogen (CEE), three groups received the same dose of CEE and various doses of the progestins medroxyprogesterone acetate or micronized progesterone, and one group received a placebo. The four groups of women who received HRT had significantly higher average blood levels of high density lipoprotein cholesterol and lower fibrinogen levels than placebo recipients. Both of these changes indicate a decrease in the risk of heart disease. Women in all treatment groups had similar average blood pressure levels and similar blood insulin levels when measured two hours after eating.

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PEPI in perspective: good answers spawn pressing questions

Article Abstract:

Results from the Postmenopausal Estrogen Progestin Interventions (PEPI) study may confirm some benefits of hormone replacement therapy (HRT) and spark interest in further research. During a three-year period, PEPI investigators studied four groups of postmenopausal women who received estrogen, different combinations of estrogen and a progestin, or a placebo to evaluate the effects of HRT on heart disease risk factors. The four HRT regimens improved risk factors for heart disease including fibrinogen levels, blood pressure, insulin levels, and lipid profiles. These results reveal that the cardioprotective effect of estrogen is not lost when it is combined with progestin. HRT does not have a negative impact on blood pressure or blood clotting. Additional research is needed to determine whether the reduction in heart disease risk factors will be followed by a reduction in heart disease.

Editorial

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Timing of postmenopausal estrogen for optimal bone mineral density: the Rancho Bernardo study

Article Abstract:

Waiting until the age of 60 to begin estrogen replacement therapy may be as beneficial as starting at menopause. Researchers measured bone density at the arm, hip and spine in 740 women 60 to 98 years old. Some of the women had never used estrogen, others were past or current users who either began taking the hormone at menopause or after the age of 60. Women who started estrogen at menopause and continued taking it had the highest bone density. However, those who started after the age of 60 and continued had similar bone density values. Women who delay treatment could reduce the costs and risks of long-term estrogen while still avoiding osteoporosis.

Planning, Bones, Hormone therapy, Bone density

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