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 .
Acute and mid-term combined hormone replacement therapy improves endothelial function in post-menopausal women with angina and angiographically normal coronary arteries.
AIMS AND BACKGROUND Coronary endothelial dysfunction improves after acute oestradiol treatment in women with angina and normal coronary angiograms . We sought to analyse whether this effect is also seen in the peripheral circulation and whether it is sustained after a mid-term period of treatment . METHODS We studied 20 women with angina , signs suggestive of myocardial ischaemia and normal coronary angiograms . In five of them , coronary and peripheral endothelial functions were studied at baseline . Brachial artery flow-mediated dilation was reanalysed after 24 h of transdermal oestradiol treatment . In the other 15 women , brachial artery vasoreactivity was studied at baseline and after a 6-week period of treatment with transdermal oestradiol and medroxyprogesterone ( HRT ) or placebo in a double-blinded crossover fashion . RESULTS An abnormal coronary artery response to acetylcholine was observed in all women as well as impaired brachial flow-mediated dilation . Brachial flow-mediated dilation significantly increased after 24 h of oestradiol treatment ( 4.8+/-0.8 % vs 0.06+/-0.6 % , P<0.001 ) . Peripheral flow-mediated dilation also increased after a 6-week period of HRT compared with baseline ( 4.1+/-3 % vs 0.4+/-1 % , P<0.01 ) and placebo treatment ( 4.1+/-3 % vs 0.6+/-1.7 % , P<0.01 ) . CONCLUSION Impaired endothelium-dependent vasodilation exists both at the coronary and peripheral circulation in post-menopausal women with angina and normal coronary angiograms .  Flow-mediated dilation improves in these women after short and mid-term therapy with transdermal oestradiol irrespective of concomitant progesterone use
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 .