Estrogens, progestins, and coronary heart disease in cynomolgus monkeys.

OBJECTIVE

To determine the effects of estrogen deprivation and estrogen replacement on coronary artery atherosclerosis.

DESIGN

Randomized trials using female cynomolgus monkeys as subjects.

SETTING

Comparative Medicine Clinical Research Center of an academic medical center.

PATIENTS

Premenopausal and postmenopausal female cynomolgus monkeys fed diets comparable in fat and cholesterol to those consumed by human beings.

INTERVENTIONS

Menopause was induced by ovariectomy; coronary vasomotion was evaluated during coronary angiography. Treatments involved estrogens and progestins, and coronary artery atherosclerosis was evaluated at necropsy.

MAIN OUTCOME MEASURE

Coronary artery atherosclerosis extent.

RESULTS

Premenopausal stress induces ovarian dysfunction and exacerbates coronary artery atherosclerosis. Physiologic replacement of ovarian hormones reduces in half the extent of coronary atherosclerosis of surgically menopausal monkeys. Hormone replacement therapy did not enhance regression of established coronary atherosclerosis.

CONCLUSION

Estrogen deprivation exacerbates and estrogen diminishes coronary artery atherosclerosis of female cynomolgus monkeys fed atherogenic diets.