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 .
Endothelin levels decrease after oral and nonoral estrogen in postmenopausal women with increased cardiovascular risk factors.
OBJECTIVE To establish levels of plasma endothelin-1 in postmenopausal women with increased CV risk as compared with healthy premenopausal women and to measure the effects of different forms of estrogen replacement on plasma endothelin-1 . DESIGN Prospect i ve r and omized study . SETTING University of Southern California Medical Center . PATIENT(S ) We studied 18 postmenopausal women ( mean age 53.4 + /- 4.9 years ) with total cholesterol levels > 240 mg/dL divided into those with and without hypertension as well as in 10 healthy premenopausal women . INTERVENTION(S ) The postmenopausal women were r and omized to receive oral estrone sulfate , transdermal E2 , or placebo for 30 days . MAIN OUTCOME MEASURE(S ) We measured the endothelin-1 levels and total cholesterol  at baseline and after 30 days of estrogen treatment . RESULT ( S ) In the postmenopausal women , endothelin-1 was higher ( 4.58 + /- 0.46 pg/mL ) compared with premenopausal levels ( 2.80 + /- 0.46 pg/mL ) . In hypertensive postmenopausal women , endothelin-1 was 5.56 + /- 0.44 pg/mL. After estrogen , plasma endothelin-1 values decreased from 5.38 + /- 0.66 to 4.82 + /- 0.9 pg/mL with oral estrone sulfate , 4.84 + /- 0.25 to 4.54 + /- 0.49 pg/mL with transdermal E2 , and did not change after placebo 4.76 + /- 0.71 to 4.81 + /- 0.46 pg/mL. In evaluating hypertensive women alone with estrogen therapy , plasma endothelin-1 showed the greatest decrement from 5.39 + /- 0.49 to 4.4 + /- 0.59 pg/mL ( 18.4 % ) . The decrease in endothelin-1 with estrogen , which was statistically significant for the entire group , did appear to be influenced by the route of administration . Baseline plasma endothelin-1 levels were correlated positively to plasma cholesterol levels with a correlation coefficient of 0.632 . CONCLUSION ( S ) These data provide another potential mechanism explaining the cardioprotective effects of hormone replacement therapy
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 .