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(Circulation. 2002;106:e9019.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Estrogen and C-Reactive Protein?

According to a new study in this week’s issue of Circulation (Circulation. 2002;106:1224–1228), 12 months of treatment with transdermal estradiol resulted in no significant increases in C-reactive protein, whereas orally conjugated equine estrogen, also given for 12 months, did increase levels of C-reactive protein, which has been associated with increased levels of heart disease.

The researchers, led by Andrea Decensi, MD, of the European Institute of Oncology in Milan, Italy, randomized 189 women to receive the estrogen patch and retinoid fenretinide, oral estrogen pills and placebo, oral estrogen pills and fenretinide, or the estrogen patch and placebo. Members of each group also took sequential medroxyprogesterone acetate.

After 6 months, C-reactive protein was increased by 10% in the group with the estrogen patch and by 48% in the group taking the oral estrogen pills. At 12 months, the C-reactive protein levels were 3% in the group on the patch and 64% in the oral estrogen group. The fenretinide had no effect.

In their introduction, the authors proposed that recent studies showed hormone replacement therapy to have no positive effect in preventing heart disease because oral estrogen might increase levels of C-reactive protein. They were attempting to determine the effect of the estrogen patch on levels of the protein.

"Because increased CRP [C-reactive protein] level is among the strongest of the risk factors for CHD [coronary heart disease] in healthy women and because its normalization is associated with a significant improvement in endothelium-dependent vascular reactivity, our findings suggest that transdermal . . . [Full Text of this Article]