Estrogen replacement therapy and progression of intimal-medial thickness in the carotid arteries of postmenopausal women. ACAPS Investigators. Asymptomatic Carotid Atherosclerosis Progression Study.
Estrogen replacement therapy and progression of intimal-medial thickness in the carotid arteries of postmenopausal women. ACAPS Investigators. Asymptomatic Carotid Atherosclerosis Progression Study.
复制标题
雌激素替代疗法和绝经后妇女颈动脉内膜中层厚度的进展。
DOI：
10.1093/oxfordjournals.aje.a117553
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发表时间：
1995
影响因子：
5
通讯作者：
Hunninghake,D
中科院分区：
文献类型：
--
作者：
Espeland,MA;Applegate,W;Furberg,CD;Lefkowitz,D;Rice,L;Hunninghake,D
采用1989-1993年无症状颈动脉粥样硬化进展研究（ACAPS）中收集的连续B型超声测量数据，探讨雌激素替代治疗（ERT）对颈动脉内膜中层厚度（IMT）3年变化的影响。入选标准包括IMT增加和低密度脂蛋白胆固醇升高。在186名绝经后ACAPS妇女中，随机分配接受安慰剂或洛伐他汀治疗，34%报告使用ERT。使用者比不使用者平均年轻3岁，具有更有利的高密度和低密度脂蛋白胆固醇水平，并且更有可能接受过直肠切除术。ERT使用者和非使用者的基线血压、体重指数和横截面IMT相似。在安慰剂组中，非ERT使用者的IMT倾向于进展，而ERT使用者的IMT则倾向于消退：平均协变量调整进展率分别为0.015 ± 0.007 mm/年和-0.012 ± 0.012 mm/年（p= 0.05）。这种差异似乎与脂蛋白浓度无关。在ERT使用者和非使用者中，洛伐他汀与低密度脂蛋白胆固醇降低约25%相关，并对这些女性的IMT进展有显著影响（p= 0.004）。ERT似乎对分配给洛伐他汀的女性的IMT几乎没有额外的影响。ERT可减少或阻止未接受活性降脂药物治疗的女性早期动脉粥样硬化的进展。美国流行病学杂志1995;142：1011-19。
The effect of estrogen replacement therapy (ERT) on 3-year changes in carotid intimal-medial thickness (IMT) was explored using serial B-mode ultrasound measurements collected during 1989–1993 as part of the Asymptomatic Carotid Atherosclerotic Progression Study (ACAPS). Eligibility included increased IMT and elevated low density lipoprotein cholesterol. Of the 186 postmenopausal ACAPS women randomly assigned to receive either placebo or lovastatin, 34% reported use of ERT. Users tended to be younger than nonusers by an average of 3 years, to have more favorable high and low density lipoprotein cholesterol levels, and to be more likely to have had hysterectomies. Baseline blood pressure, body mass index, and cross-sectional IMT were similar among ERT users and nonusers. In the placebo group, IMT tended to progress among ERT nonusers but to regress among ERT users: Mean covariate-adjusted progression rates were 0.015 ± 0.007 mm/year versus –0.012 ± 0.012 mm/year, respectively (p= 0.05). This difference appeared to be independent of lipoprotein concentrations. Lovastatin was associated with an approximately 25% lowering of low density lipoprotein cholesterol among both ERT users and nonusers and had a marked impact on IMT progression (p= 0.004) in these women. ERT appeared to have little additional effect on IMT in women assigned to lovastatin. ERT may reduce or halt the progression of early atherosclerosis in women not receiving active lipid-lowering medication.Am J Epidemiol1995;142:1011–19.