[Investigation of atherosclerosis in postmenopausal women: alteration of atherosclerosis-associated factors and vascular atherosclerosis by oral and transdermal estrogen replacement].

The incidence of cardiovascular disease (CVD) is lower in younger women than in men of the same age, but it rises after menopause, implicating aging as well as in part a decline in endogenous estrogen; however, whether hormone replacement therapy (HRT) in postmenopausal women might be effective for the prevention of CVD remains unknown. We evaluated the effects of oral conjugated equine estrogen (CEE) therapy and transdermal estradiol(E2) therapy on atherosclerosis-associated factors, such as circulating lipids, glucose, insulin, uric acid, and vascular inflammatory markers, and the vascular atherosclerosis assessment test, including blood pressure, brachial artery flow-mediated vasodilatation (FMD), brachial-ankle pulse wave velocity (baPWV), and carotid intima-media thickness (IMT), in postmenopausal women. Oral CEE therapy decreased total cholesterol, low-density lipoprotein (LDL) cholesterol, fasting blood glucose and insulin, homeostasis model assessment of insulin resistance (HOMA-R), uric acid, and cell adhesion molecules (CAMs) levels and increased triglyceride, high-density lipoprotein (HDL) cholesterol, and C reactive protein (CRP) levels. Transdermal E2 therapy decreased uric acid and CAMs and had no effect on lipids, glucose metabolism, and CRP levels. In addition, oral CEE therapy increased FMD but did not change blood pressure, baPWV, and IMT. Transdermal E2 therapy decreased or had no effect on blood pressure, increased FMD, and decreased baPWV and IMT. Thus, measurement of atherosclerosis-associated factors and the vascular atherosclerosis assessment test might be useful for the assessment of atherosclerosis by HRT in postmenopausal women, and transdermal E2, but not oral CEE therapy, may have antiatherosclerotic effects by improving vascular atherosclerosis.