This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wakatsuki, A. Articles by Sakuma, I. Search for Related Content PubMed PubMed Citation Articles by Wakatsuki, A. Articles by Sakuma, I.

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:e197.)
© 2004 American Heart Association, Inc.

Letters to the Editor

Lower Doses of Estrogen Replacement Therapy and the Risk of Cardiovascular Disease

Akihiko Wakatsuki

Department of Obstetrics and Gynecology,, Kochi Medical School, Kochi, Japan

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

In their interesting study, Koh et al demonstrated that lower dosage of oral conjugated equine estrogen (CEE) eliminated the adverse effects of conventional dosage of CEE on markers of vascular inflammation and coagulation, in addition to preserving the favorable effects of estrogen on endothelial function.¹ Similar to their report, our previous findings demonstrated that CEE at a dosage of 0.625 mg increased inflammatory markers such as C-reactive protein, serum amyloid protein A, and interleukin-6, whereas CEE at a dosage of 0.3125 mg did not elevate these markers. Additionally, low-dose CEE has an effect comparable to high-dose CEE on endothelium,² and low-dose CEE has benefits of plasma triglyceride and the size of low-density lipoprotein (LDL). High-dose CEE increases plasma concentrations of triglyceride, and this estrogen-induced increase in plasma triglyceride reduces the size of LDL particles that are more susceptible to oxidation. In contrast, plasma triglyceride concentrations and the size of LDL particles are unaffected and the oxidative susceptibility of LDL is inhibited by low-dose CEE administration.³

The Heart and Estrogen/Progestin Replacement Study and the Women’s Health Initiative reported that hormone therapy increased the risk of coronary heart disease (CHD) in postmenopausal women. In contrast, Grodstein et al demonstrated that CEE at a daily dosage of 0.625 mg increases the risk for stroke, whereas 0.3 mg of CEE daily is associated with a reduction in the risk for stroke.⁴ In addition, Ferrara et al also demonstrated that low dosage but not medium or high dosage estrogen decreased the risk . . . [Full Text of this Article]

Kwang Kon Koh; Eak Kyun Shin

Cardiology, Gil Heart Center, Gachon Medical School, Incheon, Korea

Ichiro Sakuma

Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan