Medroxyprogesterone acetate antagonizes inhibitory effects of conjugated equine estrogens on coronary artery atherosclerosis
Medroxyprogesterone acetate antagonizes inhibitory effects of conjugated equine estrogens on coronary artery atherosclerosis
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DOI：
10.1161/01.atv.17.1.217
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发表时间：
1997-01-01
影响因子：
8.7
通讯作者：
Williams, JK
中科院分区：
文献类型：
--
作者：
Adams, MR;Register, TC;Williams, JK
虽然雌激素替代治疗与冠心病风险降低和冠状动脉粥样硬化程度降低有关，但联合（雌激素加孕酮）雌激素替代治疗的效果尚不确定。一些观察数据表明，使用者的联合激素替代品，包括连续口服共轭马雌激素（CEE）和口服序贯给药（每月7至14天）醋酸甲羟孕酮（MPA）的经验，在风险降低类似于用户的CEE单独。然而，目前尚不清楚CEE + MPA（一种已获得青睐的处方模式）联合持续给药对冠心病或动脉粥样硬化风险的影响。我们研究了CEE（相当于0.625 mg/d）和MPA（相当于2.5 mg/d）单独或联合给药对手术绝经后食蟹猴冠状动脉粥样硬化程度（平均斑块大小）的影响，这些食蟹猴喂食致动脉粥样硬化饮食并接受这些激素治疗30个月。单独用CEE治疗导致动脉粥样硬化程度相对于未治疗（雌激素缺乏）对照降低72%（P
Although estrogen replacement therapy is associated with reduced risk of coronary heart disease and reduced extent of coronary artery atherosclerosis, the effects of combined (estrogen plus progestin) hormone-replacement therapy are uncertain. Some observational data indicate that users of combined hormone replacement consisting of continuously administered oral conjugated equine estrogens (CEE) and oral sequentially administered (7 to 14 days per month) medroxyprogesterone acetate (MPA) experience a reduction in risk similar to that of users of CEE alone. However, the effects of combined, continuously administered CEE plus MPA (a prescribing pattern that has gained favor) on the risk of coronary heart disease or atherosclerosis are not known. We studied the effects of CEE (monkey equivalent of 0.625 mg/d) and MPA (monkey equivalent of 2.5 mg/d), administered separately or in combination, on the extent of coronary artery atherosclerosis (average plaque size) in surgically postmenopausal cynomolgus monkeys fed atherogenic diets and treated with these hormones for 30 months. Treatment with CEE alone resulted in atherosclerosis extent that was reduced 72% relative to untreated (estrogen-deficient) controls (P