Haemostatic risk factors in healthy postmenopausal women taking hormone replacement therapy

• Published in: Maturitas 2002-10, Vol.43 (2), p.125-133
• Main Authors: Norris, L.A, Joyce, M, O'Keeffe, N, Sheppard, B.L, Bonnar, J
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Estradiol - therapeutic use; Female; Haemostatic risk factors; Hemostasis; Hormone Replacement Therapy; Hormones. Endocrine system; Humans; Medical sciences; Middle Aged; Norethindrone - analogs & derivatives; Norethindrone - therapeutic use; Norpregnenes - therapeutic use; Pharmacology. Drug treatments; Postmenopausal; Postmenopause; Risk Factors; Time Factors
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/S0378-5122(02)00202-5

Objective: To compare changes in haemostatic parameters in healthy postmenopausal women taking either tibolone or 17β-oestradiol/norethisterone acetate. Methods: Factor VIIc, antithrombin, fibrinogen, thrombin–antithrombin complex (TAT), FDP (D-Dimer), tissue plasminogen activator (tPA) and plasminogen activator inhibitor I (PAI-1) were measured in 80 healthy postmenopausal women after 3, 6 and 12 months therapy with either 17β-oestradiol/norethisterone acetate or tibolone. Results: Both treatments significantly reduced fibrinogen, factor VIIc, antithrombin, tPA and PAI-1 antigen. Significantly lower levels of factor VIIc activity were observed on treatment with tibolone compared with 17β-oestradiol/norethisterone acetate. TAT was unchanged with both treatments as was tPA activity. FDP (D-dimer) was increased on treatment with both preparations. Conclusions: The enhanced fibrin turnover and reduced antithrombin activity may play a role in the increased risk of venous thromboembolism in some susceptible women taking hormone replacement therapy (HRT) and could explain the lack of benefit of HRT in the secondary prevention of cardiovascular disease. The decreased levels of fibrinogen and factor VIIc found during treatment with 17β-oestradiol/norethisterone acetate or tibolone may offer some degree of cardioprotection in healthy woman without pre-existing disease.