Source: DGNews  |  Posted 8 years ago

By Paula Moyer

SAN DIEGO, CA -- May 18, 2003 -- Healthy African American women who take supplemental estrogen and progesterone show an increase in high-density lipoprotein (HDL) cholesterol and a reduction in the ratio of low-density lipoprotein (LDL) to HDL, according to study results presented here on May 15th at the American Association of Clinical Endocrinologists 12th Annual Meeting and Clinical Congress.

"These findings add another layer of complexity to the debate over whether hormone replacement therapy (HRT) is beneficial or harmful to women," said Nauman Qureshi, MD, an endocrinology fellow at the University of Tennessee,Memphis, Tenn. Dr. Qureshi collaborated in his study with Thomas A. Hughes, professor of endocrinology at the University of Tennessee.

"The investigators focused on African American women because most studies of HRT have primarily white subjects," Dr. Qureshi said.

"We believe that, in selected patients, [HRT] has value for the primary prevention of cardiovascular disease. HRT may normalize cholesterol in women with a family history of heart disease," said Dr. Qureshi.

Forty-two postmenopausal African American women were recruited, 45 to 65 years of age, and had no history of cerebrovascular disease, congestive heart failure, leftventricular hypertrophy, or diabetes mellitus. Thirty-five women were randomized to daily combination HRT consisting of 0.625 of conjugated estrogen and 2.5 mg of medroxyprogesterone, and 7 were randomized to placebo. All participants were followed for 12 weeks.

The investigators seperated the lipoproteins gradient ultracentrifugation into very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (ILDL), and LDL, as well as 3 HDL subfractions: light (HDL-L), medium (HDL-M), and dense (HDL-D).

The cholesterol ester increased more than 16% in HDL-L, and more than 9% in HDL-M (P=0.003 and P=0.014) respectively. However, there was no corresponding increase in HDL-D.

Overall, the women had an 8% increase in total HDL cholesterol (P=0.01). The findings showed that phospholipids increased approximately 15% in HDL-L and HDL-D (P=0.005 and P=0.037) respectively.

Dr. Qureshi attributed the absence of changes in HDL lipid ratios to the possibility that the composition of these particles was not altered.

They found an 8% reduction in the ratio of LDL to HDL (P=0.035, P=0.019). "The LDL composition measurements were not changed as a result of treatment," he said.

"We need to keep gathering more data on HRT and cholesterol," he said. "A primary prevention trial would give us useful information."

This study was funded by Wyeth Pharmaceuticals, Collegeville, Pa.

[Study title: Lipoprotein Composition Changes With Hormone Replacement Therapy (Conjugated Estrogen And Medroxyprogesterone) In AfricanAmerican Women. Abstract 11]