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Lipid predictors of coronary heart disease and tibolone users

D. Crook*

St Bartholomew's and The Royal London School of Medicine and Dentistry, London, U.K.

* Correspondence: David Crook, PhD, Department of Cardiovascular Biochemistry, St Bartholomew's and The Royal London School of Medicine and Dentistry, Charterhouse Square, London EClM 6BQ, U.K.

Abstract

Tibolone reduces plasma levels of total cholesterol by approximately 5%, triglycerides by approximately 25% and lipoprotein(a) by 20–30%, with little effect on the levels of low-density lipoproteins. In contrast to these theoretical beneficial effects, there is a 20–30% fall in levels of high-density lipoproteins (HDL). The failure of recent placebocontrolled clinical trials of hormone replacement therapy to show a cardiovascular benefit with elevated HDL levels raises the possibility that hormone replacement therapy-induced plasma lipid changes may not accurately predict clinical events. Advances in our understanding of lipoprotein metabolism, especially resulting from identification of new receptors, challenge the conventional belief that reducing HDL levels will cause cardiovascular disease.

Key Words: Coronary heart disease • high-density lipoprotein • hormone replacement therapy • lipids • tibolone

References

  1. Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med. 1999;340:1801–1811[Free Full Text]
  2. The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. JAMA. 1995;273:199–208[Abstract/Free Full Text]
  3. Speroff L. Postmenopausal hormone replacement therapy and coronary heart disease: clinical implications of recent randomized trial results. Maturitas. 2000;35:91–97[CrossRef][Medline]
  4. Zandberg P, Peters JL, Demacker PN, et al. Tibolone prevents atherosclerotic lesion formation in cholesterol-fed, ovariectomized rabbits. Arterioscler Thromb Vase Biol. 1998;18:1844–1854
  5. Clarkson TB, Anthony MS, Wagner JD. A comparison of tibolone and conjugated equine estrogens on coronary artery atherosclerosis and bone density of postmenopausal monkeys. J Clin Endocrinol. 2001;: (in press)
  6. Moore RA. Livial: a review of clinical studies. Br J Obstet Gynaecol. 1999;106(suppl 19):1–21
  7. Crook D. Cardiovascular risk assessment for postmenopausal hormone replacement therapies such as tibolone (Livial). Genazzani AR. Controversies in Cardiovascular Disease and Hormone Replacement Therapy. New York: Parthenon; 2000. p. 1–8
  8. Barnes JF, Farish E, Rankin M, Hart DM. A comparison of the effects of two continuous HRT regimens on cardiovascular risk factors. Atherosclerosis. 2001;: (in press)
  9. Schlipak MG, Simon JA, Vittinghoff E, et al. Estrogen and progestin, lipoprotein(a), and the risk of recurrent coronary heart disease events after menopause. JAMA. 2000;283:1845–1852[Abstract/Free Full Text]
  10. Crona N, Silfverstolpe G, Samsioe G. A double-blind crossover study on the effects of ORG OD 14 compared to oestradiol valerate and placebo on lipid and carbohydrate metabolism in oophorectomized women. Acta Endocrinol (Copenh). 1983;102:451–455[Abstract/Free Full Text]
  11. von Eckardstein A, Nofer JR, Assmann G. High density lipoproteins and arteriosclerosis. Role of cholesterol efflux and reverse cholesterol transport. Arterioscler Thromb Vase Biol. 2001;21:13–27
  12. Fielding C, Fielding PE. Molecular physiology of reverse cholesterol transport. J Lipid Res. 1995;36:211–228[Abstract]
  13. Castellani LW, Navab M, Lenten BJ, et al. Overexpression of apolipoprotein All in transgennc mice converts high density lipoproteins to proinflammatory particles. J Clin Invest. 1997;100:464–474[Web of Science][Medline]
  14. Plump AS, Azrolan N, Odaka H, et al. ApoA-I knockout mice: characterization of HDL metabolism in homozygotes and identification of a post-RNA mechanism of apoA-I up-regulation in heterozygotes. J Lipid Res. 1997;38:1033–1047[Abstract]
  15. Arai T, Wang N, Bezouevski M, et al. Decreased atherosclerosis in heterozygous low density lipoprotein receptor-deficient mice expressing the scavenger receptor BI transgene. J Biol Chem. 1999;274:2366–2371[Abstract/Free Full Text]
  16. Rubins HB, Robins SJ, Collins D, et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med. 1999;341:410–481[Abstract/Free Full Text]
  17. Diabetes Atherosclerosis Intervention Study Investigators. Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet. 2001;357:905–910[CrossRef][Web of Science][Medline]
  18. Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease: the Bezafibrate Infarction Prevention (BIP) study. AnonymousCirculation. 2000;102:21–27[Abstract/Free Full Text]
  19. Robins SJ, Collins D, Rubins HB. Diabetes, hyperinsulinemia and recurrent coronary events in the VA-High Density Lipoprotein Trial (VA-HIT). American Heart Association Scientific Sessions. November 12–15 2000. New Orleans, USA
  20. Walldius G, Erikson U, Olsson AG, et al. The effect of probucol on femoral atherosclerosis: the Probucol Quantitative Regression Swedish Trial (PQRST). Am J Cardiol. 1994;74:875–883[CrossRef][Web of Science][Medline]
  21. Walden CE, Retzlaff BM, Buck BL, et al. Differential effect of National Cholesterol Education Program (NCEP) step II diet on HDL cholesterol, its subfractions, and apoprotein A-I levels in hypercholesterolemic women and men after 1 year: the beFIT Study. Arterioscler Thromb Vase Biol. 2000;20:1580–1587
  22. Crook D, Von Eckardstein A, Dieplinger H, et al. Tibolone lowers HDL concentrations but does not impair cholesterol efflux from cells. Maturitas. 2000;35:S7–S8
  23. Adlouni A, El Messal M, Saile R, et al. Probucol promotes reverse cholesterol transport in heterozygous familial hypercholesterolemia. Effects on apolipoprotein AI-containing lipoprotein particles. Atherosclerosis. 2000;152:433–440[Medline]

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