Evaluation of the cardiovascular safety of menopausal hormone therapy in early postmenopausal women
Objective. To evaluate the cardiovascular safety of long-term use of a combination of 1 mg 17β-estradiol and 2 mg drospirenone (DRSP) (1 mg E2/2 mg DRSP) in early postmenopausal women.Salov I.A., Tolstov S.N., Rebrov A.P.
Subjects and methods. A total of 162 early postmenopausal women were examined and divided into 2 groups: 1) 84 patients who were on menopausal hormone therapy (MHT) with 1 mg E2/2 mg DRSP (Angeliq) (a study group); 2) 78 women who did not receive MHT (a control group). The follow-up period was 5.2 years. The severity of abdominal obesity and oral glucose tolerance test and hemostatic parameters were estimated.
Results. Long-term MHT is associated with a significant decrease in waist circumference (WC) and waist-hip ratio (WHR) throughout the follow-up period. The control group showed a significant increase in WC and WHR. Long-term MHT is associated with a decrease in the probability of developing carbohydrate metabolic disturbances (OR, 0.42; 95% CI, 0.17-1.04) and in the incidence of hypertension (OR, 0.69; 95% CI, 0.34-1.38). The circadian blood profile was normalized in women on MHT. The changes in endothelium functional activity (von Willebrand factor antigen, antithrombogenic activity of the vascular wall) suggest that long-term MHT with 1 mg E2/2 mg /DRSP had no negative impact on the endothelium.
Conclusion. The combination of 1 mg E2/2 mg DRSP used in the long-term MHT in early postmenopausal women demonstrated its efficacy, safety, and additional positive effects.
Keywords
abdominal obesity
hypertension
circadian blood profile
antithrombogenic activity of the vascular wall
menopausal hormone therapy
drospirenone
Supplementary Materials
- Table 1. Clinical characteristics of women included in the study
- Table 2. Change in indices of antithrombogenic activity of the vascular wall against the background of menopausal hormone therapy 1 mg E 2/2 mg drospirenone
- Fig. 1.
- Fig. 2.
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Received 09.03.2017
Accepted 28.04.2017
About the Authors
Igor A. Salov, MD, PhD, Head of Department of Obstetrics and Gynecology, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia.410012, Russia, Saratov, B. Kazachya str. 112. Tel.: +78452201680. E-mail: salovia@mail.ru
Sergey N. Tolstov, MD, PhD, assistant of the Department of Therapy, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia.
410012, Russia, Saratov, B. Kazachya str. 112. Tel.: +78452201680. E-mail: tolstovsn@mail.ru
Andrey P. Rebrov, MD, PhD, Head of Department of Therapy, V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia.
410012, Russia, Saratov, B. Kazachya str. 112. Tel.: +78452491437. E-mail: andreyrebrov@yandex.ru
For citations: Salov I.A., Tolstov S.N., Rebrov A.P. Evaluation of the cardiovascular safety of menopausal hormone therapy in early postmenopausal women. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (1): 69-76. (in Russian)
https://dx.doi.org/10.18565/aig.2018.1.69-76
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