Different effects of oral and transdermal hormone replacement therapies on Factor IX, APC resistance, t-PA, PAI and C- reactive protein - a cross-sectional population survey

Lowe, G.D.O., Upton, M.N., Rumley, A., McConnachie, A. , O'Reilly, D.S. and Watt, G.C.M. (2001) Different effects of oral and transdermal hormone replacement therapies on Factor IX, APC resistance, t-PA, PAI and C- reactive protein - a cross-sectional population survey. Thrombosis and Haemostasis, 86(2), pp. 550-556.

Abstract

The effects of hormone replacement therapy (HRT) on thrombosis risk, thrombotic variables, and the inflammatory marker C- reactive protein (CRP) may vary by route of administration (oral versus transdermal). We studied the relationships of 14 thrombotic variables (previously related to cardiovascular risk) and CRP to menopausal status and to use of HRT subtypes in a cross-sectional study of 975 women aged 40-59 years. Our study confirmed previously-reported associations between thrombotic variables and menopausal status. Oral HRT use was associated with increased plasma levels of Factor IX, activated protein C (APC) resistance, and CRP; and with decreased levels of tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI) activity. Factor VII levels were higher in women taking unopposed oral oestrogen HRT. The foregoing associations were not observed in users of transdermal HRT; hence they may be consequences of the "first- pass" effect of oral oestrogens on hepatic protein synthesis. We conclude that different effects of oral and transdermal HRT on thrombotic and inflammatory variables may be relevant to their relative thrombotic risk; and suggest that this hypothesis should be tested in prospective, randomised studies.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Upton, Dr Mark and McConnachie, Professor Alex and Rumley, Dr Ann and Lowe, Professor Gordon and Watt, Professor Graham and O'Reilly, Dr Denis
• Authors: Lowe, G.D.O., Upton, M.N., Rumley, A., McConnachie, A., O'Reilly, D.S., and Watt, G.C.M.
• Subjects: R Medicine > RC Internal medicine; R Medicine > RM Therapeutics. Pharmacology; R Medicine > RG Gynecology and obstetrics
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Research Group: Midspan
• Journal Name: Thrombosis and Haemostasis
• Publisher: F.K. Schattauer
• ISSN: 0340-6245
• Copyright Holders: Copyright © 2001 F.K. Schattauer
• First Published: First published in Thrombosis and Haemostasis 86(2):550-556
• Publisher Policy: Reproduced with the permission of the publisher