Estrogen Preps Differ in Effects on Heart Fat Deposits

Hormone therapy formulations have differential effects on heart fat deposits in early menopausal women, according to a study published online Aug. 1 in the Journal of the American Heart Association.

Samar R. El Khoudary, Ph.D., M.P.H., from the University of Pittsburgh, and colleagues examined the differential effects of hormone therapy formulations on heart fat accumulations and their associations with coronary artery calcification (CAC) progression in a multicenter randomized trial. A total of 727 early menopausal women were randomly assigned to 0.45 mg/day oral conjugated equine estrogens, 50 µg/day transdermal 17β-estradiol, or placebo. Four hundred seventy-four women had computed tomography-based heart fat and CAC measures at baseline and 48 months.

The researchers found that women assigned to oral equine estrogens were less likely to have any increase in epicardial adipose tissue compared with women on placebo (odds ratio, 0.62). None of the groups experienced changes in paracardial adipose tissue (PAT). There was no difference by treatment group in changes in epicardial adipose tissue and PAT. Fourteen percent of participants had increases in CAC. The association between PAT changes and CAC progression was modified by assigned treatment such that PAT increases correlated with CAC increases in the transdermal 17β-estradiol group only.

"This new evidence suggests that hormone therapy use produces different effects based on type, combination, dose, and route of administration of the preparations used," the authors write.

Pfizer supported poststudy hormone measurements; Bayer Health Care and Abbott Pharmaceuticals supplied some study medications.

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