Different Effects of Oral and Transdermal Hormone Replacement Therapies on Factor IX, APC Resistance, t-PA, PAI and C-reactive Protein

Gordon D. O. Lowe; Mark N. Upton; Ann Rumley; Alex McConnachie; Denis St. J. O’Reilly; Graham C. M. Watt

doi:10.1055/s-0037-1616085

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2001; 86(02): 550-556
DOI: 10.1055/s-0037-1616085

Review Article

Schattauer GmbH

Different Effects of Oral and Transdermal Hormone Replacement Therapies on Factor IX, APC Resistance, t-PA, PAI and C-reactive Protein

A Cross-sectional Population Survey

Autoren

Gordon D. O. Lowe

¹From the University Department of Medicine, Glasgow Royal Infirmary, Department of General Practice, University of Glasgow
Mark N. Upton

¹From the University Department of Medicine, Glasgow Royal Infirmary, Department of General Practice, University of Glasgow
Ann Rumley

¹From the University Department of Medicine, Glasgow Royal Infirmary, Department of General Practice, University of Glasgow
Alex McConnachie

¹From the University Department of Medicine, Glasgow Royal Infirmary, Department of General Practice, University of Glasgow
Denis St. J. O’Reilly

²Institute of Biochemistry, Glasgow Royal Infirmary, Glasgow, UK
Graham C. M. Watt

¹From the University Department of Medicine, Glasgow Royal Infirmary, Department of General Practice, University of Glasgow

Abstract

Summary

The effects of hormone replacement therapy (HRT) on thrombosis risk, thrombotic variables, and the inflammatory marker C-reactive protein (CRP) may vary by route of administration (oral versus transdermal). We studied the relationships of 14 thrombotic variables (previously related to cardiovascular risk) and CRP to menopausal status and to use of HRT subtypes in a cross-sectional study of 975 women aged 40-59 years. Our study confirmed previously-reported associations between thrombotic variables and menopausal status. Oral HRT use was associated with increased plasma levels of Factor IX, activated protein C (APC) resistance, and CRP; and with decreased levels of tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI) activity. Factor VII levels were higher in women taking unopposed oral oestrogen HRT. The foregoing associations were not observed in users of transdermal HRT; hence they may be consequences of the “first-pass” effect of oral oestrogens on hepatic protein synthesis. We conclude that different effects of oral and transdermal HRT on thrombotic and inflammatory variables may be relevant to their relative thrombotic risk; and suggest that this hypothesis should be tested in prospective, randomised studies.

Keywords

Oestrogens - menopause - C-reactive protein - coagulation - fibrinolysis

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Referenzen

References
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