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| Slide Lecture Programs |
| 2000 Core Curriculum |
| The endothelium: New insights into the origins and treatment of CAD |
August 31, 2000
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Update on the endothelium
- This study compared the vascular effects of estrogen and vitamin E therapies in postmenopausal women to determine mechanisms of potential cardiovascular benefit.10
- 28 healthy postmenopausal women were randomly assigned to conjugated equine estrogens (CE) 625 mg/d, vitamin E 800 IU/d, and their combination, with measurements made before and after each 6-week treatment period.
- Lipoprotein(a) levels and the ratio of LDL to HDL-cholesterol decreased significantly on therapies that included CE, but they increased on vitamin E alone.
- Brachial artery FMD improved on all therapies (all P < .001 vs pretreatment values) and to a similar degree (P = 0.267).
- CE lowered serum levels of E-selectin, as well as ICAM-1, and VCAM-1 (all P < .05 versus pretreatment values). Vitamin E had no significant effect on levels of these markers of inflammation.
- CE alone or combined with vitamin E but not vitamin E alone also lowered or showed a trend for lowering plasma levels of PAI-1 (P = .069).
- This study suggests that estrogen and vitamin E therapies similarly improve arterial endothelium-dependent vasodilator responsiveness consistent with increased NO in healthy postmenopausal women, despite having different effects on atherogenic lipoproteins. However, only estrogen reduced markers of vascular disease.
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