This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (144)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Maurizio R. Soma, PhD; Iolanda Osnago-Gadda; Rodolfo Paoletti, MD; Remo Fumagalli, MD; Joel D. Morrisett, PhD; Michele Meschia, MD; Piergiorgio Crosignani, MD

Arch Intern Med. 1993;153(12):1462-1468.

Abstract
Objective
To evaluate whether estrogen plus progesterone replacement therapy influences the plasma lipoprotein[a] (Lp[a]) levels in postmenopausal women.

Design
Fifty-five women who had been menopausal for at least 1 year were followed up for 12 months. Twenty-four subjects served as the control group and 31 subjects served as the therapy group. The therapy consisted of conjugated estrogen (1.25 mg/d) and medroxyprogesterone acetate (10 mg/d for 10 days a month). Blood samples were obtained before the start of therapy and at 6 months and 12 months after therapy. Nine subjects in the therapy group were followed up for an additional year after the treatment was suspended (washout group).

Settings
All subjects were healthy women (mean age, 52 years) who had natural menopause at least 1 year before the beginning of recruitment. None of the women had received exogenous sex steroids or drugs known to influence lipid and lipoprotein metabolism in the previous 12 months.

Main Results
In the control group, no change was noted in the plasma Lp[a] concentrations during the study. In the treatment group, the mean plasma Lp[a] concentrations decreased 50% after 6 months (P<.01) and remained at this level 12 months after treatment was started. In the washout group, mean plasma Lp[a] levels tended to return to pretherapy values. In addition, estrogen plus progesterone treatment significantly lowered total cholesterol levels by 15% and low-density lipoprotein cholesterol levels by 30%; it increased high-density lipoprotein cholesterol levels by 19%.

Conclusion
The results suggest that in estrogen plus progesterone-treated postmenopausal women, the lipid profile is improved not only by lowering low-density lipoprotein cholesterol levels and raising high-density lipoprotein levels, but also by lowering plasma Lp[a] concentrations.

(Arch Intern Med. 1993;153:1462-1468)

Author Affiliations
From the Institue of Pharmacological Sciences (Drs Soma, Paoletti, and Fumagalli and Ms Osnago-Gadda) and the Department of Obstetrics and Gynecology (Drs Meschia and Crosignani), University of Milan (Italy); and the Department of Medicine, Methodist Hospital, Baylor College of Medicine, Houston, Tex (Dr Morrisett).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Gender Differences of Cardiovascular Disease: New Perspectives for Estrogen Receptor Signaling
Meyer et al.
Hypertension 2006;47:1019-1026.
FULL TEXT  

Should Progestins Be Blamed for the Failure of Hormone Replacement Therapy to Reduce Cardiovascular Events in Randomized Controlled Trials?
Koh and Sakuma
Arterioscler. Thromb. Vasc. Bio. 2004;24:1171-1179.
ABSTRACT | FULL TEXT  

Effects of estrogen on the vascular wall: vasomotor function and inflammation
Koh
Cardiovasc Res 2002;55:714-726.
FULL TEXT  

Estrogen and Progestin, Lipoprotein(a), and the Risk of Recurrent Coronary Heart Disease Events After Menopause
Shlipak et al.
JAMA 2000;283:1845-1852.
ABSTRACT | FULL TEXT  

Cardiovascular Disease in the Diabetic Woman
Kaseta et al.
J. Clin. Endocrinol. Metab. 1999;84:1835-1838.
ABSTRACT | FULL TEXT  

Estrogen Modulation of Apolipoprotein(a) Expression. IDENTIFICATION OF A REGULATORY ELEMENT
Boffelli et al.
J. Biol. Chem. 1999;274:15569-15574.
ABSTRACT | FULL TEXT  

Lipoprotein(a) and dietary proteins: casein lowers lipoprotein(a) concentrations as compared with soy protein
Nilausen and Meinertz
Am. J. Clin. Nutr. 1999;69:419-425.
ABSTRACT | FULL TEXT  

The effect of hormone replacement therapy alone and in combination with simvastatin on plasma lipids of hypercholesterolemic postmenopausal women with coronary artery disease
Sbarouni et al.
J Am Coll Cardiol 1998;32:1244-1250.
ABSTRACT | FULL TEXT  

Metabolism of Apo(a) and ApoB100 of Lipoprotein(a) in Women: Effect of Postmenopausal Estrogen Replacement
Su et al.
J. Clin. Endocrinol. Metab. 1998;83:3267-3276.
ABSTRACT | FULL TEXT  

Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration
Espeland et al.
Circulation 1998;97:979-986.
ABSTRACT | FULL TEXT  

Female Sex Hormones and Cardiovascular Disease in Women
Skafar et al.
J. Clin. Endocrinol. Metab. 1997;82:3913-3918.
ABSTRACT | FULL TEXT  

Oral 17{beta}-Estradiol Continuously Combined with Dydrogesterone Lowers Serum Lipoprotein(a) Concentrations in Healthy Postmenopausal Women
Mijatovic et al.
J. Clin. Endocrinol. Metab. 1997;82:3543-3547.
ABSTRACT | FULL TEXT  

Effects of Estrus Cycle, Ovariectomy, and Treatment with Estrogen, Tamoxifen, and Progesterone on Apolipoprotein(a) Gene Expression in Transgenic Mice
Zysow et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:1741-1745.
ABSTRACT | FULL TEXT  

Hormonal Regulation of Lipoprotein(a) Levels: Effects of Estrogen Replacement Therapy on Lipoprotein(a) and Acute Phase Reactants in Postmenopausal Women
Tuck et al.
Arterioscler. Thromb. Vasc. Bio. 1997;17:1822-1829.
ABSTRACT | FULL TEXT  

Estrogen and Progestin Compared with Simvastatin for Hypercholesterolemia in Postmenopausal Women
Darling et al.
NEJM 1997;337:595-601.
ABSTRACT | FULL TEXT  

Lipoprotein Lp(a) Excess and Coronary Heart Disease
Stein and Rosenson
Arch Intern Med 1997;157:1170-1176.
ABSTRACT  

Medroxyprogesterone Attenuates Estrogen-Mediated Inhibition of Neointima Formation After Balloon Injury of the Rat Carotid Artery
Levine et al.
Circulation 1996;94:2221-2227.
ABSTRACT | FULL TEXT  

Plasma Lipoprotein(a) Is an Independent Factor Associated With Carotid Wall Thickening in Severely but Not Moderately Hypercholesterolemic Patients
Baldassarre et al.
Stroke 1996;27:1044-1049.
ABSTRACT | FULL TEXT  

Cardiovascular Effects of Estrogen and Lipid-Lowering Therapies in Postmenopausal Women
Guetta and Cannon
Circulation 1996;93:1928-1937.
FULL TEXT  

Effect of Oral Estradiol on Lp(a) and Other Lipoproteins in Postmenopausal Women: A Randomized, Double-blind, Placebo-Controlled, Crossover Study
Haines et al.
Arch Intern Med 1996;156:866-872.
ABSTRACT  

Association of Hormone Replacement Therapy With Hemostatic and Other Cardiovascular Risk Factors : The FINRISK Hemostasis Study
Salomaa et al.
Arterioscler. Thromb. Vasc. Bio. 1995;15:1549-1555.
ABSTRACT | FULL TEXT  

Regression of Atherosclerosis in Female Monkeys
Williams et al.
Arterioscler. Thromb. Vasc. Bio. 1995;15:827-836.
ABSTRACT | FULL TEXT  

Hormonal Regulation of Serum Lipoprotein(a) Levels : Contrasting Effects of Growth Hormone and Insulin-Like Growth Factor–I
Olivecrona et al.
Arterioscler. Thromb. Vasc. Bio. 1995;15:847-849.
ABSTRACT | FULL TEXT  

No Association Between Plasma Lipoprotein(a) Concentrations and the Presence or Absence of Coronary Atherosclerosis in African-Americans
Moliterno et al.
Arterioscler. Thromb. Vasc. Bio. 1995;15:850-855.
ABSTRACT | FULL TEXT  

How Do We Explain the Clinical Benefits of Estrogen? : From Bedside to Bench
Gerhard and Ganz
Circulation 1995;92:5-8.
FULL TEXT  

Effect of Postmenopausal Estrogen Replacement on Plasma Lp(a) Lipoprotein Concentrations
Sacks et al.
Arch Intern Med 1994;154:1106-1110.
ABSTRACT  

Review Article : The Gynecologist and Cardiovascular Disease: A Window of Opportunity for Prevention
Wild et al.
Reproductive Sciences 1994;1:107-117.
ABSTRACT