Abstract | BACKGROUND: METHODS: RESULTS: Current users had higher mean levels of high-density lipoprotein cholesterol, its subfractions high-density lipoprotein2 and high-density lipoprotein3, and apolipoprotein A-I than nonusers and lower mean levels of low-density lipoprotein cholesterol, apolipoprotein B, lipoprotein(a), fibrinogen, antithrombin III, and fasting serum glucose and insulin. However, current users of estrogen alone had higher triglyceride, factor VII, and protein C levels than either nonusers or current users of estrogen with progestin. After making certain assumptions, we estimated that the findings, if causal, would translate into a reduction of 42 percent in the risk of coronary heart disease in users of hormones as compared with nonusers. Women using estrogen with progestin would have an even greater estimated benefit. CONCLUSIONS: A randomized trial is needed to eliminate possible selection biases in our observational study that are related to the prescription of replacement hormones. Nevertheless, hormone-replacement therapy appears to be associated with a favorable physiologic profile, which probably mediates its protective effects on cardiovascular disease. The use of estrogen combined with progestin appears to be associated with a better profile than the use of estrogen alone.
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Authors | A A Nabulsi, A R Folsom, A White, W Patsch, G Heiss, K K Wu, M Szklo |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 328
Issue 15
Pg. 1069-75
(Apr 15 1993)
ISSN: 0028-4793 [Print] United States |
PMID | 8384316
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Apolipoproteins
- Blood Coagulation Factors
- Estrogens, Conjugated (USP)
- Cholesterol
- Medroxyprogesterone Acetate
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Topics |
- Apolipoproteins
(blood)
- Blood Coagulation Factors
(analysis)
- Cardiovascular Diseases
(blood, etiology, prevention & control)
- Cholesterol
(blood)
- Cross-Sectional Studies
- Estrogen Replacement Therapy
- Estrogens, Conjugated (USP)
(administration & dosage)
- Female
- Humans
- Medroxyprogesterone Acetate
(administration & dosage)
- Menopause
- Middle Aged
- Risk Factors
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