Estrogen and progestin compared with simvastatin for hypercholesterolemia in postmenopausal women

Giselle M. Darling, Jennifer A. Johns, Philip I. McCloud, Susan R. Davis

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Background Postmenopausal estrogen therapy has favorable effects on serum lipoproteins in women with normal serum lipid levels, but the effect of combined estrogen and progestin therapy on lipoproteins in women with hypercholesterolemia has not been determined, nor has it been directly compared with the effect of conventional lipid-lowering therapy. Methods In a randomized crossover trial, we studied 58 postmenopausal women with fasting serum total cholesterol levels greater than 260 mg per deciliter. Each woman received simvastatin (10 mg daily) for eight weeks and postmenopausal hormone therapy (up to 1.25 mg of conjugated equine estrogens daily, along with 5 mg of medroxyprogesterone acetate daily) for eight weeks, with an eight-week washout period between the two treatment phases. Results At base line, the mean (±SD) cholesterol values were as follows: total cholesterol, 305±39 mg per deciliter; high-density lipoprotein (HDL) cholesterol, 62±19 mg per deciliter; and low-density lipoprotein (LDL) cholesterol, 217±39 mg per deciliter. For total cholesterol, the mean decrease with hormone therapy was 14 percent (95 percent confidence interval, 11 to 16 percent) and the mean decrease with simvastatin was 26 percent (95 percent confidence interval, 23 to 29 percent). For LDL cholesterol, the mean decrease was 24 percent (96 percent confidence interval, 20 to 28 percent) with hormone therapy and 36 percent (95 percent confidence interval, 32 to 40 percent) with simvastatin. The effect of simvastatin was significantly greater than that of hormone therapy (P

Original languageEnglish
Pages (from-to)595-601
Number of pages7
JournalThe New England Journal of Medicine
Issue number9
Publication statusPublished - 28 Aug 1997

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