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Atherosclerosis protection afforded to some. (Estradiol Therapy).

ASHLAND, ORE. -- Obese postmenopausal women on lipid-lowering therapy appear to derive no additional protection against atherosclerosis when they take unopposed estradiol, but obese and nonobese women with normal cholesterol levels do seem to benefit.

That was the conclusion of a subgroup analysis of data derived from the Estrogen in the Prevention of Atherosclerosis Trial (EPAT), a randomized, double-blind, placebo-controlled trial that examined progression of subclinical atherosclerosis in healthy postmenopausal women. Results were presented in poster form at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society.

In the study, 199 women were randomized to receive either unopposed estradiol or placebo. Progression of atherosclerosis was evaluated using sequential tests to detect changes in intima media thickness over 2 years.

A cutoff of 30 kg/[m.sup.2] was used to distinguish obese from nonobese women, said Dr. Afshan Hameed and associates at the University of Southern California, Los Angeles.

At entry to the trial, all subjects who had a basal LDL cholesterol level greater than 160 mg/dL were placed on statin therapy Members of this group included 76 nonobese subjects and 46 obese subjects. Those who were assigned to receive estradiol therapy showed the same rate of progression of atherosclerosis over 2 years as those who were assigned to placebo.

Also included in the study were 77 women with normal cholesterol levels, including 31 who were obese.

In this group, estrogen conferred a significant protection against atherosclerosis progression in both obese and nonobese subjects.

Being thinner made no difference in the degree of protection offered by estradiol therapy if a woman's cholesterol level was normal, Dr. Hameed said.
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Author:Bates, Betsy
Publication:OB GYN News
Date:Jan 15, 2002
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