HRT pills, patches and heart disease risk factors

University Park, Pa. --- The different effects of oral vs. transdermal hormone replacement therapy (HRT) on heart disease risk factors make a woman's choice between taking estrogen via pill or patch more than a convenience issue, says a Penn State researcher.

Dr. Sheila West, assistant professor of biobehavioral health, is lead author of a new study, which is one of the first to look at the effects of the estrogen pill vs. the patch on heart disease risk factors beyond blood pressure and cholesterol.

The study results showed that the HRT pill and patch had similar positive effects on the tightness or constriction of blood vessels, total cholesterol and low-density lipoprotein cholesterol (LDLs, the "bad" cholesterol). However, the research team found different effects on high density lipoprotein (HDLs, the "good" cholesterol) and triglycerides depending on whether the woman was taking HRT pills or using a patch to deliver estrogen.

In addition, the study found that women who used either the estrogen pill or the patch had lower blood pressure during psychological stress. West says this blood pressure lowering effect might be a new way to explain how estrogen protects women from heart disease.

"Women may have special reasons for wanting to choose the patch or the estrogen pill," says the Penn State researcher. "If, for example, a woman has low HDLs, she might choose oral HRT since subjects in our study and other studies showed no change in the beneficial HDLs while on transdermal therapy. "On the other hand, a woman might want to select the patch if her triglycerides were already high, since oral therapy increases this factor which is associated with a higher risk of heart disease." The study is detailed in the April issue of the American Journal of Obstetrics and Gynecology in a paper, "Transdermal Estrogen Reduces Vascular Resistance and Serum Cholesterol in Postmenopausal Women." West conducted the study as part of her

Contact: Barbara Hale
Penn State

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