RANDOMIZED TRIAL OF ESTROGEN-ATHEROSCLEROSIS REGRESSION

冠心病（CHD）已成为导致 60岁以上妇女的死亡率。 关于血脂的知识- 降低或其他干预措施，可能有助于防止 冠状动脉进展或导致冠状动脉消退 绝经后妇女的动脉粥样硬化 根本不存在 血浆中抗肿瘤药物作用的随机对照试验 降低胆固醇对冠心病的影响不包括女性。 观察性流行病学研究检查了 绝经后妇女使用雌激素与冠心病之间的关系 报告了相互矛盾的结果。 这项拟议研究的意义在于，它将提供一个 妇女试验的基础，并可能提供基础， 绝经后高脂蛋白血症的合理管理 妇女 这项研究的结果将在几个方面具有重要意义。 a）研究将确定是否以及在多大程度上 雌激素替代治疗减少冠状动脉粥样硬化 在雌激素缺乏的绝经后猴子中， 降低胆固醇的饮食; B）结果将使我们能够确定 是否以及在多大程度上添加了一种维生素A（Provera）， 雌激素替代疗法会减少任何有益的 雌激素替代治疗的效果;亚组分析 根据随机化前的数据，另外两个问题将 回答：c）激素治疗对患者的影响是什么？ HDL亚类和LDL分子量，都是已知的 与动脉粥样硬化病变有关吗 最后，d）什么是 血浆性激素结合水平之间的关系 球蛋白与冠状动脉粥样硬化程度的关系？ 这项研究是我们所知道的第一次努力， 利用非人类随机试验的方法， 评价冠状动脉粥样硬化的灵长类人群 干预 此外，它是对NIH赞助的 PEPI（绝经后雌激素/孕激素干预）研究 它的目的是确定不同的 雌激素/孕激素制剂对CHD和骨质疏松症风险的影响 因素和其他因素，以及它们的安全性。

Coronary heart disease (CHD) has become the leading cause of death among women beyond age 60. Knowledge about lipid- lowering or other interventions that may be useful in preventing progression or causing regression of coronary artery atherosclerosis among postmenopausal women is essentially nonexistent. Randomized trails of the effect of plasma cholesterol lowering on CHD have not included women. Observational epidemiologic studies examining the association between estrogen use and CHD in postmenopausal women have reported contradictory results. The significance of this proposed study is that it will provide a foundation for trials in women and may provide a basis for the rational management of hyperlipoproteinemic postmenopausal women. The results of this study will have significance in several areas: a) the study will determine whether and to what extent estrogen replacement decreases coronary artery atherosclerosis among estrogen-deficient postmenopausal monkeys on a cholesterol lowering diet; b) the results will allow us to determine whether and to what extent the addition of a progestin (Provera) to the estrogen replacement therapy will diminish any beneficial effect of estrogen replacement therapy; in subgroup analyses based on the prerandomization data, two additional questions will be answered: c) What is the effect of hormonal therapy on the HDL subclasses and the LDL molecular weight, all known to be associated with atherosclerotic lesions? and finally, d) What is the relationship between the plasma levels of sex hormone binding globulin and the degree of coronary atherosclerosis? The study represents the first effort that we are aware of to utilize the methodology of a randomized trial in a nonhuman primate population to evaluate a coronary atherosclerosis intervention. Moreover, it is a complement to the NIH-sponsored PEPI (Postmenopausal Estrogen/Progestin Interventions) study which is designed to determine the effect of different estrogen/progestin preparations on CHD and osteoporosis risk factors and other factors, as well as their safety.