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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.

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.

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  • Authors+Show Affiliations

    ,

    Inserm U888, Montpellier, France.

    , , , , , ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Cardiovascular Diseases
    Cholesterol
    Clofibric Acid
    Drug Therapy, Combination
    Estrogen Replacement Therapy
    Female
    France
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Hyperlipidemias
    Hypolipidemic Agents
    Risk Factors
    Surveys and Questionnaires
    Triglycerides

    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 -