Hormone replacement therapy effectiveness and safety in postmenopausal women with metabolic syndrome

Aim. То compare the effects of hormone replacement therapy (HRT) and antihypertensive therapy (AHT) on metabolic profile, insulin resistance (IR) and central hemodynamics in postmenopausal women with metabolic syndrome (MS).

Material and methods. In total, 46 postmenopausal women with MS were examined. Group I (n=30) received estradiol (1 mg/day) and drospirenone (2 mg/day) for 6 months (Angeliq medication). Group II (n=16) received various antihypertensive medications. At baseline and after 6 months of the treatment, lipid profile, glycemia and insulinemia, IR index HOMA-IR, body composition, Kuperman index (modified by E..M. Vikhlyaeva) were assessed, 24-hour blood pressure monitoring (BPM) and echocardiography were performed.

Results. In Group I, body mass index (BMI) reduced from 30,9 kg/m² to 30,2 kg/m² (p=0,068); in Group II, it increased from 30,6 kg/m2to 31,3 kg/m² (p=0,003). Visceral fat tissue percentage was 40,6 %. at baseline and 42,2 % after 6 months in Group I, comparing to 41,0 % and 42,2 %, respectively, in Group II (p=0,018). Angeliq medication demonstrated good antihypertensive activity. In Group I, left ventricular myocardial mass index (LVMMI) significantly reduced from 116,1 g/m² to 110,8 g/m² (p<0,0001); in Group II, it decreased from 116,4 g/m² to 112,7 g/m² only (p=0,062). HRT did not affect metabolic profile.

Conclusion. Angeliq medication was effective and safe in women with high cardiovascular risk, with no adverse effect on metabolic profile or IR. Due to its anti-mineralocorticoid action, Angeliq improved central hemodynamics parameters and reduced BR.

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