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Oral conjugated equine estrogen increases plasma von Willebrand factor in postmenopausal women.

Abstract：

OBJECTIVES:We sought to test whether one month of daily oral conjugated equine estrogen (CEE) or transdermal estradiol alters hemostatic factors in postmenopausal subjects. BACKGROUND:Estrogen replacement therapy and hormonal replacement therapy (HRT) effect an early increase in cardiovascular events in postmenopausal women. Circulating plasma von Willebrand factor (vWF) antigen is a marker of generalized endothelial dysfunction and atherothrombosis. METHODS:Thirty-eight healthy postmenopausal women (average 59 +/- 7 years) were randomized to receive daily oral CEE, 0.625 mg (n = 21); transdermal estradiol, 0.1 mg/day (n = 7); or oral placebo (n = 10) for one month. Blood samples were collected at baseline and after two weeks and four weeks of therapy for measurement of circulating plasma hormones, lipid concentrations, and hemostatic factors. RESULTS:Oral CEE decreased total cholesterol (p < 0.01) and low-density lipoprotein cholesterol (p < 0.01), although it increased both triglycerides (p < 0.05) and high-density lipoprotein cholesterol (p < 0.01). Transdermal estradiol had no significant effect on lipids. Plasminogen activator inhibitor-1 antigen declined in both oral CEE and transdermal estradiol users, but did not achieve statistical significance. Fibrin D-dimer antigen did not vary significantly in any group. However, oral CEE users had a significant increase in vWF from baseline to four weeks (p < 0.03) and a decrease in tissue-type plasminogen activator antigen from baseline to four weeks (p < 0.004), which was significantly different from the change observed in the transdermal estradiol group (p < 0.05). CONCLUSIONS:These data suggest that the oral CEE-mediated increase in plasma vWF may have clinical relevance given the early atherothrombotic effects of HRT in postmenopausal women.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Rabbani LE,Seminario NA,Sciacca RR,Chen HJ,Giardina EG

doi

10.1016/s0735-1097(02)02565-2

subject

Has Abstract

pub_date

2002-12-04 00:00:00

pages

1991-9

issue

eissn

0735-1097

issn

1558-3597

pii

S0735109702025652

journal_volume

pub_type

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Oral conjugated equine estrogen increases plasma von Willebrand factor in postmenopausal women.