Mercuro Giuseppe, Vitale Cristiana, Fini Massimo, Zoncu Sandra, Leonardo Filippo, Rosano Giuseppe M C
Cardiovascular Research Unit, Department of Internal Medicine, San Raffaele Hospital, Rome, Italy.
Int J Cardiol. 2003 Jun;89(2-3):257-65. doi: 10.1016/s0167-5273(02)00505-3.
To compare the effect of low (0.3 mg) and commonly prescribed (0.625 mg) doses of conjugated equine estrogens (CEE) on brachial artery flow-mediated dilation and lipid profiles.
Twenty-five postmenopausal women (mean age, 65+/-6 years) at risk for coronary artery disease (CAD) (> or =2 established risk factors) entered a double-blind crossover study. Brachial artery endothelial function was evaluated by means of high-resolution vascular echography. Both CEE doses significantly decreased total cholesterol (-13%, 0.3 mg; -15%, 0.625 mg), low-density lipoprotein-cholesterol (LDL-C) (-15%, 0.3 mg; -16%, 0.625 mg), and lipoprotein(a) (-28%, 0.3 mg; -39%, 0.625 mg) values from baseline levels. Both treatments increased high-density lipoprotein-cholesterol (HDL-C) (5%, 0.3 mg; 7%, 0.625 mg) and triglycerides (3%, 0.3 mg; 8%, 0.625 mg). There was no dose effect for changes in the LDL-C/HDL-C ratio (-21%, 0.3 mg; -23%, 0.625 mg). Both doses improved brachial artery dilation during reactive hyperemia by 63% over baseline.
In women at risk for CAD, low-dose hormone replacement treatment (HRT) improves lipid profiles and brachial artery endothelial function comparably to the most commonly prescribed dose. The benefit:risk ratio of low-dose HRT provides an attractive option for postmenopausal women at risk for CAD.
比较低剂量（0.3毫克）和常用剂量（0.625毫克）的结合马雌激素（CEE）对肱动脉血流介导的血管舒张和血脂谱的影响。
25名有冠状动脉疾病（CAD）风险（≥2个已确定的风险因素）的绝经后女性（平均年龄，65±6岁）进入一项双盲交叉研究。通过高分辨率血管超声评估肱动脉内皮功能。两种CEE剂量均使总胆固醇（-13%，0.3毫克；-15%，0.625毫克）、低密度脂蛋白胆固醇（LDL-C）（-15%，0.3毫克；-16%，0.625毫克）和脂蛋白(a)（-28%，0.3毫克；-39%，0.625毫克）值从基线水平显著降低。两种治疗均使高密度脂蛋白胆固醇（HDL-C）升高（5%，0.3毫克；7%，0.625毫克）和甘油三酯升高（3%，0.3毫克；8%，0.625毫克）。LDL-C/HDL-C比值的变化没有剂量效应（-21%，0.3毫克；-23%，0.625毫克）。两种剂量均使反应性充血期间的肱动脉扩张比基线提高63%。
在有CAD风险的女性中，低剂量激素替代治疗（HRT）改善血脂谱和肱动脉内皮功能的效果与最常用剂量相当。低剂量HRT的效益风险比为有CAD风险的绝经后女性提供了一个有吸引力的选择。
