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Effects of hormone replacement therapy on plaque stability, inflammation, and fibrinolysis in hypertensive or overweight postmenopausal women

Observational studies of the long-term effects of hormone replacement therapy (HRT) have generally demonstrated favorable cardiovascular effects. 1 The beneficial effects of HRT may involve nonlipid mechanisms that affect endothelial function: plaque stability, inflammatory responses, and fibrinolysis. Hypertension and obesity are associated with “insulin resistance syndrome” and a prothrombic state. 2,3 Accordingly, HRT may not have comparable benefit in hypertensive or overweight postmenopausal women. Although inflammation of the arterial wall in the vicinity of atherosclerotic plaques (especially those with rupture and thrombi) is often found at necropsy, this manner of identification is hardly useful in patients at risk for myocardial infarction and stroke. Thus, we investigated serologic markers after HRT in hypertensive or overweight postmenopausal women. Twenty postmenopausal women (mean age ± SD 60 ± 7 years) participated in this study, all with plasma 17β-estradiol levels <50 pg/ml and cessation of menses for at least 1 year. Baseline lipoprotein levels are listed in Table 1 . We used the National Heart, Lung, and Blood Institute’s definitions 4 for overweight and obesity as cutoff points (body mass index ≥25.0 and ≥30.0 kg/m 2 , respectively). We defined systolic or diastolic blood pressure ≥140 or ≥90 mm Hg, respectively, according http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The American Journal of Cardiology Elsevier
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