Hormone Replacement Therapy and the Prevalence of Coronary Artery Disease in Type II Diabetic Postmenopausal Women

Cassondra Snow, Shrieraam Sathyanarayanan, William Paiva, Kathleen Curtis

Abstract


Conflicting results exist about the effect of hormone replacement therapy (HRT) on the prevalence of coronary artery disease (CAD) in postmenopausal women. Given that CAD is the most common cause of death in Type II diabetic women, better understanding of this issue is particularly important for postmenopausal women with Type II diabetes. Accordingly, this project utilized a database of de-identified electronic medical records to investigate the prevalence of CAD in postmenopausal Type II diabetic women between the ages of 55-75 with or without HRT. Further analysis of two of the most common HRTs, premarin and estrace, was conducted to compare their effects on the prevalence of CAD. There was no difference in CAD prevalence in Type II diabetic postmenopausal women with or without HRT. In addition, there was no difference between the two forms of HRT, premarin and estrace, in the prevalence of CAD. These findings may have important implications for management of post-menopausal symptoms in women with Type II diabetes.

Keywords


Premarin, Conjugated Estrogen, Estrace, Estradiol, Coronary Heart Disease

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References


Cardiovascular Disease and Diabetes; American Heart Association; updated: Apr 14, 2017. http://www.heart.org/HEARTORG/Conditions/More/Diabetes/WhyDiabetesMatters/Why-Diabetes-Matters_UCM_002033_Article.jsp#.WUV13KMo670 [downloaded 2017 June, 17]

Cerner Corporation (2014). Health Facts Overview; from Health Facts Overview.

Coronary Heart Disease. Arlington, VA: American Diabetes Association; updated June 27, 2014. http://www.diabetes.org/living-with-diabetes/treatment-and-care/women/coronary-heart-disease.html [downloaded 2017 June, 17].

Crawford M, Mendoza-Vasconez A, Larsen B. (2015). Type II diabetes disparities in diverse women: The potential roles of body composition, diet, and physical activity. Womens Health (London) 11, 913-927.

Decensi A, Omodei U, Robertson C, Bonanni B, Guerrieri-Gonzaga A, Ramazzotto F, et al. (2002). Effect of transdermal estradiol and oral conjugated estrogen on C-reactive protein in retinoid-placebo trial in healthy women. Circulation 106, 1224-1228.

Eckel L. (2011). The ovarian hormone estradiol plays a crucial role in the control of food intake in females. Physiology and Behavior 104, 517-524.

Geary N and Asarian L. (1999). Cyclic estradiol treatment normalizes body weight and test meal size in ovariectomized rats. Physiology and Behavior 67, 141-147.

Gillum R, Mussolino M, Madans J. (2000). Diabetes Mellitus, coronary heart disease incidence, and death from all causes in African American women- the NHANES I epidemiologic follow-up. Journal of Clinical Epidemiology 53, 511-518.

Graves N, Hayes H, Liming F, Curtis, K. (2011). Time course of behaviorial, physiological, and morphological changes after estradiol treatment of ovarectomized rats. Physiology and Behavior 103, 261-267.

Jewett P, Gangnon R, Trentham-Dietz A, Sprague B. (2014). Trends of postmenopausal estrogen plus progestin prevalance in the United States between 1970 and 2010. Obstetrics and Gynecology 124, 727-733.

Kalyani R, Lazo M, Ouyang P, Turkbey E, Chevalier K, Brancati F, Becker D, Vaidya D. (2014). Sex differences in diabetes and risk of incident coronary artery disease in healthy young and middle-aged adults. Diabetes Care 37, 830-838.

Kanaya A, Grady D, Barrett-Connor E. (2002). Explaining the sex differences in coronary heart disease mortality among patients with Type 2 Diabetes Mellitus. Archives of Internal Medicine 162, 1737-1745.

Koh K, Kang M, Jin D, Lee S, Ahn J, Hwang H, et al. (2001). Vascular effects of estrogen in Type II Diabetic postmenopausal women. Journal of the American College of Cardiology 38, 1409-1415.

Lamon-Fava S, Herrington D, Horvath K, Schaefer E, Asztalos B. (2010). Effect of hormone replacement therapy on plasma lipoprotein levels and coronary atherosclerosis progression in postmenopausal women according to Type 2 Diabetes Mellitus status. Metabolism 59, 1794-1800.

Lim S, Caballero A, Arora S, Smakowski P, Bashoff E, Brown F, et al. (1999). The effect of hormonal replacement therapy on the vascular reactivity and endothelial function of healthy individuals and individuals with Type II Diabetes. Journal of Clinical Endocrinology and Metabolism 84, 4159-4164.

de Padua Mansur A, Silva T, Takada J, Avakiam S, Strunz C, Cesar L, et al. (2012). Long-term prospective study of the influence of estrone levels on events in postmenopausal women with or at high risk for coronary artery disease. Science World Journal, doi:10.1100/2012/363595.

Mongraw-Chaffin M, Peters S, Huxley R, Woodward M. (2015). The sex-specific relationship between body mass index and coronary heart disease: A systematic review and meta-analysis of 95 cohorts with 1.2 million participants. Lancet: Diabetes and Endocrinology 3, 437-449.

Pradhan AD, Manson JE, Rossouw JE, Siscovick DS, Mouton CP, Rifai N, et al. (2002). Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: Prospective analysis from the Women's Health Initiative observational study. Journal of the American Medical Association 288, 980-987.

Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. (2002), Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial. Journal of the American Medical Association 288, 321-333.

Santen R, Allred D, Ardoin S, Archer D, Boyd N, Braunstein G, et al. (2010). Executive summary: Postmenopausal hormone therapy: An endocrine society scientific statement. Journal of Clinicanl Endocrinology and Metabolism 95, S1-S66.

Shufelt C, Merz C, Prentice R, Pettinger B, Rossouw J, Aroda V, et al. (2014). Hormone therapy dose, formulation, route of delivery, and risk of cardiovascular events in women: Findings from the WHI observational study. Menopause 21, 260-266.

Wellons M, Ouyang P, Schreiner P, Herrington D, Vaidya D. (2012) Early menopause predicts future coronary heart disease and stroke: The multi-ethnic study of atherosclerosis (MESA). Menopause 19: 1081-1087.


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