EFFECTS OF NATURAL ESTROGEN/GESTAGEN AND THIAZIDE ON CORONARY RISK FACTORS IN NORMAL POSTMENOPAUSAL WOMEN

Abstract

A 2-year double-blind trial designed for studying the separate and combined effects of bendroflumethiazide (BFTZ) and cyclical administration of 17β-estradiol + estriol/norethisterone (E/N) on coronary risk factors and bone mineral loss (reported elsewhere) was undertaken. Serum lipids, fasting blood glucose, body weight and blood pressure were measured every 3 months in 97 normal women in their early menopause. All participants received a supplement of 500 mg calcium and were randomized to one of the following treatment groups: 1) placebo (P) + P (n = 33); 2) P + E/N (n = 21); 3) BFTZ + E/N (n = 22); and 4) BFTZ + P (n = 21). As compared with placebo BFTZ raised serum cholesterol by 6.0% (p <0.01), decreased systolic and diastolic blood pressures (p <0.01) and reduced body weight (p <0.001). E/N decreased serum cholesterol by 9.8% (p <0.001) and diastolic blood pressure to the same extent as BFTZ (p <0.01), but left systolic blood pressure unchanged. Neither BFTZ nor E/N affected serum triglycerides or blood glucose significantly. During their combined use E/N easily overcame the hypercholesterolemic action of BFTZ, as serum cholesterol remained 6.5% and 12.5% below the mean values of the placebo and BFTZ group, respectively (p <0.001). The tendency of both BFTZ and E/N to raise serum triglycerides was added to cause a significant increase of 6.5% (p <0.01). No other additive effects were observed. In conclusion, the thiazide increased one (serum cholesterol) and decreased another (blood pressure) of the important coronary risk factors, whereas cyclical estrogen/-gestagen reduced both risk factors, also when given in combination with thiazide.