ABSTRACT
This double blind randomized placebo controlled study assessed the effects of atorvastatin, estradiol and norethisterone, isolated and in combination, on the lipid profile and on vascular reactivity, in post-menopausal women with hypercholesterolemia and arterial hypertension. Ninety-four women aged 5065 were selected. All have received dietary counseling (4 weeks), placebo (4 weeks), and drug therapy (12 weeks): 17- estradiol 2mg/day (E) (n = 17); E + norethisterone acetate 1 mg/day (P) (n = 18); torvastatin 10 mg/day (A) (n = 20); E + A (n = 21) and E + P + A (n = 18). All treatment modalities have significantly reduced total cholesterol (TC) (E = 8.8%, E + P = 10.1%, A = 27.9%, A + E = 29.4% and E + P + A = 35.7%) and LDL-cholesterol (LDL-c) levels (E + P + A = 46.6%, E + A = 45.9%, A = 40.2%, E = 20.3%, and E + P = 12.1%). As concerns HDL-cholesterol (HDL-c), Groups E and E + A had increases of 15.5% and 13.1%, respectively. The addition of a progesterone compound reduced its concentration (Group E + P = −9.1%, and Group E + P + A = −9.5%). By random, approximately half of the patients in each group were designated to the endothelial function evaluation (brachial artery ultrasound). We observed that in Group A (n = 10), in Group E (n = 10) and with the association (Group E + A) (n = 7), there was a significant increase in the flow-mediated vasodilatation as compared to basal measurements. The addition of a progestin has annulled these benefits. Conclusions: Atorvastatin has promoted more beneficial effects on TC and LDL-c, whereas estradiol was responsible for an increase in HDL-c. The addition of a progesterone derivative abolished these benefits. Atorvastatin, estradiol or both together improved endothelial function, an effect suppressed by the addition of norethisterone.
