For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .
Oral conjugated equine estrogen increases plasma von Willebrand factor in postmenopausal women.
OBJECTIVES We sought to test whether one month of daily oral conjugated equine estrogen ( CEE ) or transdermal estradiol alters hemostatic factors in postmenopausal subjects . BACKGROUND Estrogen replacement therapy and hormonal replacement therapy ( HRT ) effect an early increase in cardiovascular events in postmenopausal women . Circulating plasma von Willebr and factor ( vWF ) antigen is a marker of generalized endothelial dysfunction and atherothrombosis . METHODS Thirty-eight healthy postmenopausal women ( average 59 + /- 7 years ) were r and omized to receive daily oral CEE , 0.625 mg ( n = 21 ) ; transdermal estradiol , 0.1 mg/day ( n = 7 ) ; or oral placebo ( n = 10 ) for one month . Blood sample s were collected at baseline and after two weeks and four weeks of therapy for measurement of circulating plasma hormones , lipid concentrations , and hemostatic factors . RESULTS Oral CEE decreased total cholesterol ( p < 0.01 ) and low-density lipoprotein cholesterol ( p < 0.01 ) , although it increased both triglycerides ( p < 0.05 ) and high-density lipoprotein cholesterol ( p < 0.01 ) . Transdermal estradiol had no significant effect on lipids . Plasminogen activator inhibitor-1 antigen declined in both oral CEE and transdermal estradiol users , but did not achieve statistical significance . Fibrin D-dimer antigen did not vary significantly in any group . However , oral CEE users had a significant increase in vWF from baseline to four weeks ( p < 0.03 ) and a decrease in tissue-type plasminogen activator antigen from baseline to four weeks ( p < 0.004 ) , which was significantly different from the change observed in the transdermal estradiol group ( p < 0.05 ) . CONCLUSIONS These data suggest that the oral CEE-mediated increase in plasma vWF may have clinical relevance given the early atherothrombotic effects of HRT in postmenopausal women
For non-oral HT , decreases in lipoprotein(a ) , cell adhesion molecules , and factor VII generally were significant , resistance to activated protein C ( APCr ) was slightly increased , and other markers including CRP and homocysteine did not change .
Compared with oral HT , changes in CRP and APCr were smaller , changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller , whereas changes in other factors including lipoprotein(a ) and homocysteine did not differ .
( S ) Potentially unfavorable changes seen with oral HT on two important markers , CRP and APCr , are substantially smaller with non-oral HT .
Non-oral HT has minor effects on the other cardiovascular risk markers studied .
Therefore , compared with oral HT , non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk
OBJECTIVE To review the effects of non-oral administration of postmenopausal hormone therapy ( HT ) on risk markers for atherosclerotic and venous thromboembolic disease .
Non-oral postmenopausal HT appears not to increase venous thromboembolic risk , whereas the effect on coronary heart disease risk is less clear .