Atherosclerosis: the benefits of hormone therapy

Hormone therapy would have a retarding effect on heart disease.

THE ESSENTIAL

Thanks to the data from the Elite study, researchers claim to have better understood the anti-inflammatory effect of estrogen during pre-menopause, thus better protecting women against cardiovascular disease.

Unexpected, or rather confirmed, effect for hormonal therapy. According to the results of theElite study (early and late intervention trial with estradiol [une forme d’œstrogène, NDLR]), produced between 2004 and 2013 by the University of Southern California (United States), and unveiled on September 28, 2020 during the congress of the North American Menopause Society, estrogen prevents heart disease and in particular the progression of atherosclerosis.

Atherosclerosis is a chronic inflammatory process of blood vessels which is at the heart of most cases of cardiovascular disease. However, the risk of cardiovascular disease in women increases rapidly after menopause and remains the leading cause of death among American women. Data from the Elite study had already demonstrated the benefits of hormone therapy in reducing the progression of atherosclerosis in relatively young, healthy postmenopausal women. There, this new study refines that knowledge and identifies which biomarkers of inflammation in postmenopausal women involved in Elite are affected by hormone treatment. A way to better understand the underlying mechanism.

Very protective estradiol for those about to have their menopause

As a reminder during this study, 643 postmenopausal women received esoral tradiol or placebo. The researchers then measured the concentrations of 12 inflammatory biomarkers. Thus, they confirm that this form of estrogen does indeed have a beneficial effect by significantly reducing the levels of a number of key biomarkers. However, these effects are the most notorious on women 6 years from their menopause, compared to women who had their menopause 10 years earlier.

“In the total sample, the average levels of E-selectin, ICAM-1, IFNγ and IL-8 [tous des biomarqueurs de l’inflammation, NDLR] during the trials were significantly lower in the hormone therapy group compared to the placebo-treated women”says Dr. Roksana Karim, lead author of the study and researcher at the Keck School of Medicine at the University of Southern California.

However, only E-selectin levels decreased for women who received hormone therapy 10 or more years after their menopause, compared to those who received a placebo. “This study helps us better understand the potential physiological mechanisms that could explain why hormone therapy slows the progression of heart disease early after menopause, but not in women further from the menopausal transition.explains Dr. Stéphanie Faubion, medical director of NAMS. Further research is needed to better understand how time since menopause alters the influence of hormone therapy on heart disease risk.”