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Lipid levels and cardiovascular risk in elderly women: a general population study of the effects of hormonal treatment and lipid-lowering agents.
Climacteric 2008; 11(1):74-83C

Abstract

OBJECTIVE

To evaluate plasma lipid levels in elderly women in the general population as a function of use of lipid-lowering agents (LLA) and hormone therapy (HT).

METHODS

A total of 4271 women aged over 65 years were recruited from three French cities. Analyses were performed after stratification by LLA treatment and HT and adjusting for a large range of sociodemographic and clinical factors.

RESULTS

Fifteen percent of women currently used HT (78% transdermal estradiol), and 30% were taking LLA. In this population, 4.6% of women were taking both HT and LLA (fibrate for 2.4% and statin for 2.2%). In non-LLA-treated women, current HT was associated with lower total cholesterol, low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) compared to never users. Women treated with LLA also had lower total cholesterol, LDL-C, and non-HDL-C compared to non-LLA users, whereas triglyceride levels were the highest in statin users and lowest in fibrate users. Fibrate use was associated with a more favorable lipid pattern than statin treatment independently of HT use. In women without coronary heart disease or diabetes, HT, statin or fibrate use were associated with lower LDL-C level risk based on National Cholesterol Education Program guidelines (adjusted odds ratio (OR) = 0.67 (95% confidence interval (CI) = 0.53-0.85), 0.38 (95% CI = 0.29-0.47), and 0.32 (95% CI = 0.25-0.42), respectively) with a possible interaction between fibrate and HT (0.18 (95% CI = 0.10-0.30)).

CONCLUSIONS

Estradiol-based HT may lower atherogenic lipoproteins in postmenopausal women. In primary prevention of coronary heart disease, combining HT and a fibrate may provide additional benefits compared to fibrate use.

Authors+Show Affiliations

Inserm U888, Montpellier, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18202967

Citation

Dupuy, A-M, et al. "Lipid Levels and Cardiovascular Risk in Elderly Women: a General Population Study of the Effects of Hormonal Treatment and Lipid-lowering Agents." Climacteric : the Journal of the International Menopause Society, vol. 11, no. 1, 2008, pp. 74-83.
Dupuy AM, Carrière I, Scali J, et al. Lipid levels and cardiovascular risk in elderly women: a general population study of the effects of hormonal treatment and lipid-lowering agents. Climacteric. 2008;11(1):74-83.
Dupuy, A. M., Carrière, I., Scali, J., Cristol, J. P., Ritchie, K., Dartigues, J. F., ... Ancelin, M. L. (2008). Lipid levels and cardiovascular risk in elderly women: a general population study of the effects of hormonal treatment and lipid-lowering agents. Climacteric : the Journal of the International Menopause Society, 11(1), pp. 74-83. doi:10.1080/13697130701877108.
Dupuy AM, et al. Lipid Levels and Cardiovascular Risk in Elderly Women: a General Population Study of the Effects of Hormonal Treatment and Lipid-lowering Agents. Climacteric. 2008;11(1):74-83. PubMed PMID: 18202967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipid levels and cardiovascular risk in elderly women: a general population study of the effects of hormonal treatment and lipid-lowering agents. AU - Dupuy,A-M, AU - Carrière,I, AU - Scali,J, AU - Cristol,J-P, AU - Ritchie,K, AU - Dartigues,J-F, AU - Gambert,P, AU - Ancelin,M-L, PY - 2008/1/19/pubmed PY - 2008/4/29/medline PY - 2008/1/19/entrez SP - 74 EP - 83 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric VL - 11 IS - 1 N2 - OBJECTIVE: To evaluate plasma lipid levels in elderly women in the general population as a function of use of lipid-lowering agents (LLA) and hormone therapy (HT). METHODS: A total of 4271 women aged over 65 years were recruited from three French cities. Analyses were performed after stratification by LLA treatment and HT and adjusting for a large range of sociodemographic and clinical factors. RESULTS: Fifteen percent of women currently used HT (78% transdermal estradiol), and 30% were taking LLA. In this population, 4.6% of women were taking both HT and LLA (fibrate for 2.4% and statin for 2.2%). In non-LLA-treated women, current HT was associated with lower total cholesterol, low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) compared to never users. Women treated with LLA also had lower total cholesterol, LDL-C, and non-HDL-C compared to non-LLA users, whereas triglyceride levels were the highest in statin users and lowest in fibrate users. Fibrate use was associated with a more favorable lipid pattern than statin treatment independently of HT use. In women without coronary heart disease or diabetes, HT, statin or fibrate use were associated with lower LDL-C level risk based on National Cholesterol Education Program guidelines (adjusted odds ratio (OR) = 0.67 (95% confidence interval (CI) = 0.53-0.85), 0.38 (95% CI = 0.29-0.47), and 0.32 (95% CI = 0.25-0.42), respectively) with a possible interaction between fibrate and HT (0.18 (95% CI = 0.10-0.30)). CONCLUSIONS: Estradiol-based HT may lower atherogenic lipoproteins in postmenopausal women. In primary prevention of coronary heart disease, combining HT and a fibrate may provide additional benefits compared to fibrate use. SN - 1369-7137 UR - https://www.unboundmedicine.com/medline/citation/18202967/Lipid_levels_and_cardiovascular_risk_in_elderly_women:_a_general_population_study_of_the_effects_of_hormonal_treatment_and_lipid_lowering_agents_ L2 - http://www.tandfonline.com/doi/full/10.1080/13697130701877108 DB - PRIME DP - Unbound Medicine ER -