This study compares the effects of long-term
hormone replacement therapy on the
lipid profile of postmenopausal women with or without
hypercholesterolemia, with a comparison of 2 different regimens over a 3-year period. A total of 209 women were enrolled in this prospective, nonrandomized trial. They were classified into 2 groups according to baseline serum levels of total
cholesterol and
low-density lipoprotein (
LDL) cholesterol. The hypercholesterolemic group consisted of 83 subjects with a total
cholesterol level of 220 mg/dL or higher and
LDL cholesterol 140 mg/dL or higher. The normocholesterolemic group consisted of 126 subjects with normal total and
LDL cholesterol levels.
Therapy was assigned as follows: 44 subjects in the hypercholesterolemic group and 67 in the normal
cholesterol group with a total
hysterectomy received
conjugated equine estrogen (CEE) 0.625 mg/d, while 39 subjects in the hypercholesterolemic group and 59 in the normal
cholesterol group with a physiological menopause received CEE 0.625 mg/d plus
medroxyprogesterone acetate 2.5 mg/d. Fasting blood samples were monitored periodically for 3 years. Nine women withdrew from the study.
Hormone replacement therapy had a more favorable effect in the hypercholesterolemic group versus the normal
cholesterol group by decreasing total and
LDL cholesterol, 7.0% and 16.6%, versus the normal
cholesterol group, 0.8% and 3.9%. Serum levels of
high-density lipoprotein (
HDL) cholesterol were increased in both groups (hypercholesterolemic, 14.4%; normal
cholesterol group, 26.5%), with the increase being larger in the normal
cholesterol group. These changes were similar with both treatments and were maintained over 3 years. Serum levels of
triglyceride were also increased in both groups, with the increase being statistically significant only in the group with normal
cholesterol levels at baseline. There were no consistently reported side effects of
therapy. The effects of
postmenopausal hormone replacement therapy,
estrogen with or without
progestin, on the
lipid profile appear to be related to the subject's baseline
lipid values. Thus, such
therapy may have a more favorable effect on
LDL cholesterol in postmenopausal women with
hypercholesterolemia, with the beneficial effect being maintained over 3 years.