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European Heart Journal 2000 21(3):190-197; doi:10.1053/euhj.1999.1582
Copyright © 2000 by the European Society of Cardiology.
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Effects of simvastatin only or in combination with continuous combined hormone replacement therapy on serum lipid levels in hypercholesterolaemic post-menopausal women

A.S Faka, M Erenusb, H Tezcana, O Caymaza, P AtagündüZc, S Oktayd and A Oktaya,f1

a Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
b Department of Obstetrics and Gynecology, Marmara University School of Medicine, Istanbul, Turkey
c Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
d Departmnet of Clinical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey

revised February 22, 1999; accepted February 24, 1999

Abstract

Aims To evaluate the effects of simvastatin only or combined with continuous hormone replacement therapy on the serum lipid profile in hypercholesterolaemic post-menopausal women.

Methods and Results One hundred hypercholesterolaemic post-menopausal women were given either simvastatin 10mg daily together with oestrogen 0·625mg and medroxyprogesterone 2·5mg daily (HRT+simvastatin group) (n:50) or simvastatin 10mg daily (simvastatin only group) (n:50) in a prospective manner. Serum total, low density lipoprotein, and high density lipoprotein cholesterol and triglyceride levels were measured at baseline, at 3 and 6 months. The initial mean (±SD) cholesterol values were as follows for the HRT+simvastatin group and the simvastatin only group, respectively: total cholesterol 240·0±28·0 and 248·9±28·2mg.dl–1; low density lipoprotein cholesterol 174·7±25·6 and 175·1±25·9mg.dl–1; high density lipoprotein cholesterol 37·2±5·0 and 39·9±7·3mg.dl–1. Compared with the baseline, total and low density lipoprotein cholesterol levels decreased; and high density lipoprotein cholesterol levels increased significantly at 3 and 6 months in both groups. However, the mean percent reduction in total cholesterol and low density lipoprotein cholesterol was significantly greater in the HRT+ simvastatin group compared with the simvastatin only group both at 3 months (12·3±7·0% vs 8·9±6·2%;P<0·01; and 19·0±10·6% vs 13·2±10·4%;P< 0·005, respectively) and at 6 months (14·6±7·7% vs 11·3±7·4%;P<0·05 and 23·3±9·7% vs 15·8±12·3%;P<0·005, respectively). The mean percent increase in serum high density lipoprotein cholesterol concentrations was also significantly greater in the HRT+simvastatin group compared with the simvastatin only group at both times (14·6±11·8% vs 9·8±11·8%;P<0·005, at 3 months, and 21·3±15·2% vs 11·1±12·5;P<0·005, at 6 months, respectively). Furthermore, significantly more patients in the HRT+simvastatin group than in the simvastatin only group attained their target treatment goals dictated by the National Cholesterol Education Program Adult Treatment Panel II Guidelines. Although the mean percent decrease in triglyceride levels was significantly greater in the HRT+simvastatin group at 3 months, the significance disappeared at 6 months.

Conclusion The combination of simvastatin and continuous combined hormone replacement therapy seems to be more effective than simvastatin only in the treatment of hypercholesterolaemia in post-menopausal women.

Key Words: Simvastatin, hormone replacement therapy, oestrogen, progesterone, hypercholesterolaemia

f1 Correspondence: Prof. Ahmet Oktay, Head, Department of Cardiology, Marmara University School of Medicine, Altunizade, 81190, stanbul, Turkey.

References

  1. Stamfer MJ, Colditz GA, Willet WC. Postmenopausal estrogen therapy and cardiovascular disease: ten year follow-up from the Nurses' Health Study. N Engl J Med. 1991;325:756–762[Abstract]
  2. Stampfer MJ, Colditz GA. Estrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiological evidence. Prev Med. 1991;20:47–63[CrossRef][ISI][Medline]
  3. Nabulshi AA, Folsom AR, White A. Association of hormone-replacement therapy with various cardiovascular risk factors in postmenopausal women. N Engl J Med. 1993;328:1069–1075[Abstract/Free Full Text]
  4. Rijpkema AHM, van der Sanden AA, Rujis AHC. Effects of postmenopausal oestrogen-progestogen replacement therapy on serum lipids and lipoproteins. Maturitas. 1990;12:259–285[CrossRef][ISI][Medline]
  5. Lobo RA. Clinical review: effects of hormonal replacement on lipids and lipoproteins in postmenopausal women. J Clin Endocrinol Metab. 1991;73:925–930[ISI][Medline]
  6. Sempos CT, Cleeman JL, Carroll MD. Prevalence of high blood cholesterol among US adults an update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel. JAMA. 1993;269:3009–3014[Abstract]
  7. JAMA. 1993;269:3015–3023[CrossRef][ISI][Medline]
  8. Lancet. 1994;344:1383–1389[CrossRef][ISI][Medline]
  9. Bradfort RH, Downton M, Chremos AN. Efficacy and tolerability of lovastatin in 3390 women with moderate hypercholesterolemia. Ann Intern Med. 1993;118:850–855[Abstract/Free Full Text]
  10. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502[Abstract]
  11. Ann Intern Med. 1992;117:1038–1041[ISI][Medline]
  12. Castelli WP, Garison RJ, Wilson PW, Abbot RD, Kalovsdian S, Kannel WB. Incidence of coronary heart disease and lipoprotein cholesterol levels. The Framingham Heart Study. JAMA. 1986;256:2835–2838[Abstract]
  13. JAMA. 1984;251:351–364[Abstract]
  14. Akahoshi M, Soda M, Nakashima E, Shimaoka K, Seto S, Yano K. Effects of menopause on trends of serum cholesterol, blood pressure and body mass index. Circulation. 1996;94:61–66[Abstract/Free Full Text]
  15. Barret-Connor, E, Bush, TL, Estrogen and coronary heart disease in women, JAMA, 1991, 265, 1861, 7
  16. Grodstein F, Stampfer MJ, Colditz G. Postmenopausal hormone replacement therapy and mortality. N Engl J Med. 1997;336:1769–1775[Abstract/Free Full Text]
  17. Samaan SA, Crawford MH. Estrogen and cardiovascular function after menopause. J Am Coll Cardiol. 1995;26:1403–1410[Abstract]
  18. JAMA. 1995;273:199–208[Abstract]
  19. Davidson M, Testolin LM, Maki KC, von Duvillard S, Drennan K. A comparison of estrogen replacement, pravastatin, and combined treatment for the management of hypercholesterolemia in postmenopausal women. Arch Intern Med. 1997;157:1186–1192[Abstract]
  20. Darling GM, Johns JA, McCloud PI, Davis SR. Estrogen and progestin compared with simvastatin for hypercholesterolemia in postmenopausal women. N Engl J Med. 1997;337:595–601[Abstract/Free Full Text]
  21. Denke MA. Effects of continuous combined hormone-replacement therapy on lipid levels in hypercholesterolemic postmenopausal women. Am J Med. 1995;99:29–35[CrossRef][ISI][Medline]
  22. Walsh BW, Schiff I, Rosner B. Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N Engl J Med. 1991;325:1196–1204[Abstract]
  23. Endo A. The discovery and development of HMG-CoA reductase inhibitors. J Lipid Res. 1992;33:1569–1582[ISI][Medline]
  24. Illingworth DR, Stein EA, Knopp RH. A randomized multicenter trial comparing the efficacy of simvastatin and fluvastatin. J Cardiovasc Pharmacol Therapeut. 1996;I:23–30
  25. Cardiology. 1994;85:244–254[CrossRef][ISI][Medline]
  26. Sbarouni E, Kyriakides ZS, Kremastinos DT. The effect of hormone replacement therapy alone and in combination with simvastatin on plasma lipids of hypercholesterolemic postmenopausal women with coronary artery disease. J Am Coll Cardiol. 1998;32:1244–1250[Abstract/Free Full Text]
  27. Larsen ML, Illingworth DR. Drug treatment in dyslipoproteinemia. Med Clin North Am. 1994;78:225–246[ISI][Medline]
  28. Bersot TP, Mahley RW. A preliminary report on the sensitivity of plasma lipoproteins to low-dose simvastatin in nine Turkish men. Arch Turkish Soc Cardiol. 1998;26:40–46
  29. Tikkanen MJ, Nikkilä EA, Kuusi T, Sipinen SU. Post-menopausal hormone replacement therapy: effects on serum lipids and lipoproteins: a review. Maturitas. 1986;8:7–17[CrossRef][ISI][Medline]
  30. Jacobs DR Jr, Mebane IL, Bangdiwala SI, Criqui MH, Tyroler HA. High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women. Arch Intern Med. 1993;153:2209–2216[Abstract]
  31. Hogan T. Health and economic issues in the prevention of coronary artery disease. Am J Cardiol. 1995;76:140A–142A[CrossRef][Medline]

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