O.I. Mitchenko, V.Yu. Romanov, G.Ya. Ilyushina. Dyslipidemia and surrogate markers of atherosclerosis in patients with essential hypertension, physiological and post-surgery menopause

The aim – to compare characteristics of lipid metabolism and early markers of atherosclerosis (thickness of intima – media complex and atherosclerotic plaques in the carotid arteries) in patients with essential hypertension (ЕH), physiological and post-surgery menopause, and possible impact of hormone replacement therapy (HRT).

Material and methods. 112 women with ЕH II stage (46.14±1.60 years) were examined: I group – 37 patients with ЕH II, post-surgery menopause without HRT; II group – 37 patients with ЕH II, post-surgery menopause, receiving combined HRT; III group – 38 patients with ЕH II and physiological menopause without HRT.

Results. Patients with ЕH and post-surgery menopause without HRT are characterized by the highest percentage of dyslipidemia (86.5 %), mainly due to higher levels of total cholesterol, LDL cholesterol, significant increase (P<0.01) of the complex intima – media of the carotid arteries compared to other groups, in 83.7 % carotid atherosclerotic plaques were detected. Patients with hypertension, post-surgery menopause, receiving HRT, despite less percentage of dyslipidemia, demonstrate effective implementation of primary cardiovascular prevention due to antiatherogenic actions of HRT. They have better condition of vessels, even compared to the comparable age patients with early physiological menopause. Conclusions. Usage of HRT in the reproductive age women with ЕH and post-surgery menopause is associated with better lipid metabolism, may reveal antiatherogenic effects upon vascular wall and be recommended as an option for primary cardiovascular prevention. Detection of the carotid atherosclerotic plaque may indicate necessity of using phytoestrogens, or other non-hormonal alternative therapies.

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