| Objective:The present study aimed to assess the influence of cardiovascular risk factors after Estrogen plus progestin therapy initiation in healthy peri-and postmenopausal population.Method:Data of Pubmed,MEDLINE,EMBASE,Cochrane Library,and Web of Science were comprehensively searched for relevant studies in English and Chinese which were published during January 1998 to December 2017.Completing the search,we selected the literature that met our inclusion and exclusion criteria which designed before,and then the relevant data was extracted.The meta-analysis was made using the RevMan5.3 software.Results:A total of 12 RCTs were included in the study.1.Seven studies recorded specific values for changes in systolic blood pressure and diastolic blood pressure.There were 193 women in the MHT group and 163 women in the control group.The Meta-analysis shows no significant difference between the two groups.Then stratified the analysis further,and showed that group with lower baseline blood pressure appeared more lower systolic blood pressure,MD=-3.99,95% CI(-4.95,-3.03),P<0.00001,but in baseline systolic blood pressure ≥128mmHg group,MD = 8.07,95% CI(0.76,15.31),P = 0.03,there were significant differences between MHT and control groups.2.Eight studies recorded specific value changes for plasma TC,LDL-C,HDL-C,and TG in both MHT and control groups as the endpoint.According to different intervention measures,MHT group were divided into two subgroups: Transdermal administration group(t-MHT)enrolled 69 women received MHT and 57 women as control and oral administration group(o-MHT)including 299 women with MHT vs 177 women as control.The Meta-analysis showed:(1)TC in MHT group VS control group,MD =-0.30,95% CI(-0.49,-0.10),Z = 3.02,P = 0.003 <0.05,there was significant difference.In the t-MHT subgroup,MD =-0.17,95% CI(-0.61,-0.28),Z = 0.73,P = 0.46> 0.05,the difference was not statistically significant.But in the o-MHT subgroup,MD =-0.32,95% CI(-0.61,-0.03),Z = 2.05,P = 0.03 <0.05,the difference was statistically significant.(2)LDL-C in MHT group VS control group,MD =-0.27,95% CI(-0.46,-0.07),Z = 2.65,P = 0.008 <0.05,the difference was statistically significant.In the t-MHT subgroup,MD =-0.09,95% CI(-0.40,0.21),Z = 0.60,P = 0.55> 0.05,the difference was not statistically significant.But in the o-MHT subgroup,MD =-0.35,95% CI(-0.59,-0.11),Z = 2.88,P = 0.004 <0.05,the difference was statistically significant.(3)Compared levels of HDL-C in MHT group VS control group,MD =-0.00,95% CI(-0.14,-0.15),Z=0.07,P = 0.95>0.05.There was no significant difference both between MHT group or it’s subgroup and control groups.(4)There was higher level of TG in MHT group compared with the control group,MD = 0.03,95% CI(0.01,0.05),Z = 2.63,P = 0.009 <0.05,the difference was statistically significant.The same result in t-MHT group MD = 0.04,95 %CI(0.01,0.06),Z = 2.93,P = 0.003 <0.05;but in o-MHT group MD = 0.00,95% CI(-0.06,0.05),Z = 0.11,P = 0.91> 0.05.(5)The level of Lp(a)in the MHT group VS control group,MD =-2.94,95% CI(-9.34,3.46),Z = 0.9,P = 0.37> 0.05.There was no significant difference between the two groups.In the t-MHT subgroup,MD = 1.21,95% CI(-0.29,2.12),Z = 2.59,P = 0.010 <0.05,the difference was statistically significant;but in o-MHT subgroup,MD =-4.08,95% CI(-12.45,4.29),Z = 0.96,P = 0.34> 0.05.3.The incidence of adverse events did not differ significantly across groups [OR = 1.21,95% CI(0.50,2.94),P = 0.68].Conclusions:1.It is a solid proof that MHT improving plasma levels of TC and LDL-C in peri-and postmenopausal women,especially more impacting in the oral route than in the transdermal route of hormone therapy;2.No changes in blood pressure were observed with MHT in healthy menopausal women,but due to the small amount of data,more clinical studies were needed. |
PDF Full Text Request