Print Email Facebook Twitter Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: A systematic review Title Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: A systematic review Author Hemelaar, M. van der Mooren, M.J. Rad, M. Kluft, C. Kenemans, P. TNO Kwaliteit van Leven Publication year 2008 Abstract Objective: To review the effects of non-oral administration of postmenopausal hormone therapy (HT) on risk markers for atherosclerotic and venous thromboembolic disease.Non-oral postmenopausal HT appears not to increase venous thromboembolic risk, whereas the effect on coronary heart disease risk is less clear. Design: Systematic review of literature obtained from MEDLINE, EMBASE, and CENTRAL databases from 1980 until and including April 2006. Terms for "postmenopausal hormone therapy" and for "non-oral administration" were combined in the search. Setting: Randomized clinical trials. Patient(s): Postmenopausal women, both healthy and with established cardiovascular disease or specified cardiovascular risk factors. Intervention(s): Non-oral HT (e.g., transdermal or intranasal) compared with oral HT or no treatment/placebo. Main Outcome Measure(s): Lipoprotein(a), homocysteine, C-reactive protein (CRP), cell adhesion molecules, markers of endothelial dysfunction, coagulation, and fibrinolysis. Result(s): Seventy-two studies investigating either transdermal or intranasal administration were included. For non-oral HT, decreases in lipoprotein(a), cell adhesion molecules, and factor VII generally were significant, resistance to activated protein C (APCr) was slightly increased, and other markers including CRP and homocysteine did not change. Compared with oral HT, changes in CRP and APCr were smaller, changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller, whereas changes in other factors including lipoprotein(a) and homocysteine did not differ. Conclusion(s): Potentially unfavorable changes seen with oral HT on two important markers, CRP and APCr, are substantially smaller with non-oral HT. Non-oral HT has minor effects on the other cardiovascular risk markers studied. Therefore, compared with oral HT, non-oral HT appears be safer with respect to atherosclerotic and venous thromboembolic disease risk. © 2008 American Society for Reproductive Medicine. Subject Biologycardiovascular diseaseintranasalPostmenopausal hormone therapyrisk factorstransdermalvenous thromboembolismactivated protein Cantithrombinblood clotting factor 7C reactive proteincell adhesion moleculechlormadinone acetateconjugated estrogencyproterone acetate plus estradiol valeratedydrogesteronedydrogesterone plus estradiolendothelin 1estradiolestradiol valerateestrone sulfategestodenehomocysteinehormonelipoproteinmedrogestonemedroxyprogesterone acetaten(g),n(g) dimethylargininenomegestrol acetatenorethisterone acetateplaceboprogesteroneprotein Cprotein Sprothrombinarticleatherosclerosisblood clottingcardiovascular riskclinical trialdrug effectdrug mechanismendothelial dysfunctionfibrinolysisfollow uphormonal therapyhumaninflammationischemic heart diseaseoutcome assessmentpostmenopausepriority journalsystematic reviewvenous thromboembolismAdministration, OralAtherosclerosisBiological MarkersEstrogen Replacement TherapyEstrogensFemaleHumansIncidenceRisk AssessmentRisk FactorsVenous Thrombosis To reference this document use: http://resolver.tudelft.nl/uuid:7994f620-bb3b-4383-ac78-b4885b4074fe DOI https://doi.org/10.1016/j.fertnstert.2007.07.1298 TNO identifier 240981 ISSN 0015-0282 Source Fertility and Sterility, 90 (3), 642-672 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.