Lipid Profile Tied to Heart Risk with Hormone Replacement

LDL to HDL cholesterol ratio of 2.5 or greater associated with higher risk
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THURSDAY, May 22 (HealthDay News) -- Lipid profiles have predictive value in determining the risk of coronary heart disease events in postmenopausal women taking hormone replacement therapy, according to an article published in the June issue of the American Journal of Cardiology.

Paul F. Bray, M.D., of Jefferson Medical College in Philadelphia, and colleagues conducted a nested case-control analysis of data from two Women's Health Initiative trials, which randomized postmenopausal women to receive hormone replacement with conjugated equine estrogen (CEE) alone, or CEE plus medroxyprogesterone acetate (MPA), or placebo. The researchers compared baseline lipids and high-sensitivity C-reactive protein (hs-CRP) levels from 271 patients with incident coronary heart disease and 707 controls, in order to investigate whether these biomarkers predicted coronary heart disease events.

The researchers found that favorable lipid levels at baseline were associated with better coronary heart disease outcomes among those taking CEE with or without MPA. Women with a low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol ratio of 2.5 or greater had an increased risk of coronary heart disease (odds ratio 1.73). The investigators report that hs-CRP levels added little or no additional predictive value beyond the LDL/HDL cholesterol ratio.

"Women considering the use of postmenopausal hormone therapy should determine their overall cardiac risk and specifically their lipid profile," the authors conclude.

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