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Low-dose HT similar to standard dose, placebo for some CV effects
In postmenopausal women undergoing hormone therapy, a low-dose regimen does not appear to differ from the standard dose or placebo in its effects on weight, BMI, blood pressure, C-reactive protein or HDL cholesterol, according to recent findings.
In the systematic review with meta-analysis, researchers evaluated 28 relevant randomized clinical trials with 3,360 patients published between January 1990 and August 2013 to determine the effect of low-dose estrogen HT compared with standard dose and placebo in postmenopausal women without an established cardiovascular disease.
The conventional dose of HT was defined as at least 0.625 mg of conjugated equine estrogen or equivalent doses of other estradiol formulations. Low-dose HT was defined as up to 0.3 mg equine estrogen and equipotent doses of other estradiol formulations.
The researchers found that compared with placebo or standard-dose HT, low-dose HT did not have an effect on weight, BMI, BP, C-reactive protein or HDL cholesterol.
Compared with placebo, low-dose HT yielded lower concentrations of total cholesterol (–12.16 mg/dL; 95% CI, –17.41 to –6.92) and LDL cholesterol (–12.16; 95% CI, –16.55 to –7.77). Compared with conventional-dose HT, the low-dose formulation was linked to higher total cholesterol (5.05 mg/dL; 95% CI, 0.88-9.21) and LDL cholesterol (4.49 mg/dL; 95% CI, 0.59-8.39).
Although there were no differences in triglycerides between low-dose HT and placebo, oral low-dose HT yielded lower triglycerides compared with conventional dose (–14.09; 95% CI, –24.2 to –3.93).
“In conclusion, the present results support the notion that low-dose HT does not differ from placebo or conventional dose HT regarding effects on weight, BMI, BP, [C-reactive protein] and HDL-[cholesterol] in younger and apparently healthy postmenopausal women,” the researchers wrote. “Low-dose HT was associated with better lipid profile compared to placebo, and induced higher total LDL cholesterol and lower triglycerides vs. conventional dose HT. Further studies are needed to explain the mechanisms involved in the effects of low-dose HT as well as different routes of administration on traditional and nonconventional CV risk factors.”
Disclosure: The researchers report no relevant financial disclosures.