This Article  • 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 ISI (10)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cardiovascular System  • Women's Health  • Women's Health, Other  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

The Healthy Women Study

Rachel H. Mackey, PhD, MPH; Lewis H. Kuller, MD, DrPH; Kim Sutton-Tyrrell, DrPH; Rhobert W. Evans, PhD; Richard Holubkov, PhD; Karen A. Matthews, PhD

Arch Intern Med. 2005;165:510-515.

Background  The Women’s Health Initiative (WHI) clinical trial found no reduction in coronary heart disease events among hormone therapy (HT) users despite an improvement in lipid levels. We hypothesized that a lack of benefit of HT on atherosclerosis would be better explained by the lipoprotein subclasses than by standard lipid levels. To test this hypothesis, we evaluated differences in coronary calcification, lipids, and lipoprotein subclasses among HT users and nonusers in a longitudinal study of the menopause.

Methods  Lipoprotein subclasses determined by nuclear magnetic resonance spectroscopy and coronary artery calcification (CAC) determined by electron beam computed tomography were compared between HT users (49%) and nonusers among 243 women, approximately 8 years postmenopausal, from the Healthy Women Study.

Results  The distribution of CAC scores was not significantly different between HT users and nonusers. As expected, HT users had higher levels of large high-density lipoprotein (HDL) particles and large very low-density lipoprotein (VLDL) particles. However, despite lower low-density lipoprotein (LDL) cholesterol levels among HT users, there were no significant differences between HT users and nonusers in any LDL subclass measures, including particle size or concentration. Regardless of HT use, women with CAC had higher levels of large VLDL and small LDL particles, higher LDL particle concentration, and smaller mean LDL size compared with women with no detectable CAC.

Conclusions  Compared with nonusers, HT users had higher levels of VLDL particles (triglycerides) and did not have a better LDL subclass distribution, which may explain the failure of HT to be associated with a difference in CAC in our study or with a reduction in coronary heart disease risk in randomized clinical trials.

Author Affiliations: Departments of Epidemiology, Graduate School of Public Health (Drs Mackey, Kuller, Sutton-Tyrrell, Evans, and Matthews) and Psychiatry (Dr Matthews), University of Pittsburgh, Pittsburgh, Pa; and Department of Family and Preventive Medicine, University of Utah, Salt Lake City (Dr Holubkov).

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

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Metabolic Syndrome
Cornier et al.
Endocr. Rev. 2008;29:777-822.
ABSTRACT | FULL TEXT  

Lipoprotein Particle Concentrations May Explain the Absence of Coronary Protection in the Women's Health Initiative Hormone Trials
Hsia et al.
Arterioscler. Thromb. Vasc. Bio. 2008;28:1666-1671.
ABSTRACT | FULL TEXT  

Vascular Actions of Estrogens: Functional Implications
Miller and Duckles
Pharmacol. Rev. 2008;60:210-241.
ABSTRACT | FULL TEXT  

Lipid levels and the risk of ischemic stroke in women
Kurth et al.
Neurology 2007;68:556-562.
ABSTRACT | FULL TEXT