Women in early menopause who received oral estradiol treatment had a reduced progression of lipid deposition in the carotid arterial wall compared with placebo, according to a secondary analysis of the ELITE trial presented at the American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions.
“Our results show that the progression of lipid deposition was significantly less among early postmenopausal women taking [estradiol therapy] than the late postmenopausal women compared with placebo,” Roksana Karim, PhD, MBBS, associate professor of clinical preventive medicine at the University of Southern California Keck School of Medicine in Los Angeles, told Healio. “These results show that [estradiol therapy] has a direct effect in reducing atherosclerosis, the major cause of CVD, by reducing cholesterol accumulation in the arterial wall.
Researchers analyzed data from 643 postmenopausal women who were randomly assigned 1 mg estradiol or placebo at early menopause, defined as less than 6 years, or late menopause, defined as more than 10 years.
The atherosclerosis outcome was defined as gray-scale median. Both this and serum concentrations of estradiol were assessed every 6 months for up to 5 years.
Estradiol therapy had significantly different effects on women depending on whether they were in early or late menopause (P for interaction = .006). In women in early menopause, the annual gray-scale median progression rate decreased by –0.3 per year in women assigned estradiol (95% CI, –0.63 to 0.04) compared with –1.41 in those assigned placebo (95% CI, –1.77 to –1.06). This rate did not differ in both treatment groups for women in late menopause (P = .37).
Women in early menopause had a stronger and significant association between mean on-trial estradiol level and the progression rate of gray-scale median (0.008 pg/mL; 95% CI, 0.0007-0.016) vs. those in late menopause (0.003 pg/ml; 95% CI, –0.006 to 0.01). The differential association between these two factors was not statistically significant (P for interaction = .33).
“Our results reassure health care providers with respect to prescribing [estradiol therapy] to postmenopausal women, particularly women early after menopause who are not at high risk of cardiovascular disease,” Karim said in an interview. “In addition to the known benefits of [estradiol therapy] on menopausal symptoms and bone loss, our data confirm the [estradiol therapy] beneficial effects on cardiovascular disease.”– by Darlene Dobkowski
Karim R, et al. Abstract MP09. Presented at: American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions; March 3-6, 2020; Phoenix.
Disclosures: The authors report no relevant financial disclosures.