Year: 2020
Type: article
Abstract: The Kronos Early Estrogen Prevention Study (KEEPS) was a randomized, double-blind, placebo-controlled trial designed to determine the effects of hormone treatments (menopausal hormone treatments [MHTs]) on the progression of carotid intima-medial thickness (CIMT) in recently menopausal women. Participants less than 3 years from menopause and without a history of overt cardiovascular disease (CVD), defined as no clinical CVD events and coronary artery calcium < 50 Agatston units, received either oral conjugated equine estrogens (0.45 mg/day) or transdermal 17β-estradiol (50 µg/day), both with progesterone (200 mg/day for 12 days/month), or placebo pills and patches for 4 years. Although MHT did not decrease the age-related increase in CIMT, KEEPS provided other important insights about MHT effects. Both MHTs versus placebo reduced the severity of menopausal symptoms and maintained bone density, but differed in efficacy regarding mood/anxiety, sleep, sexual function, and deposition of β-amyloid in the brain. Additionally, genetic variants in enzymes for metabolism and uptake of estrogen affected the efficacy of MHT for some aspects of symptom relief. KEEPS provides important information for use of MHT in clinical practice, including type, dose, and mode of delivery of MHT recently after menopause, and how genetic variants in hormone metabolism may affect MHT efficacy on specific outcomes.
Source: Climacteric
Institutions: Mayo Clinic, Yale University, New York University, Brigham and Women's Hospital, Harvard University, University of Wisconsin–Madison, University of Wisconsin Health, Mayo Clinic in Arizona, University of California, San Francisco, George Washington University, Phoenix VA Health Care System, Kronos Longevity Research Institute
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Mayo Foundation for Medical Education and Research, Aurora Foundation, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Neurological Disorders and Stroke, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1068201143, Effects of estrogen on brain morphology and neuronal integrity in early menopause, Sex-specific Risk for Vascular Dysfunction and Cognitive Decline, G1478994338, Clinical and Translational Science Institute, Estrogen, Platelets, and Artherosclerosis, Prevention of Alzheimer's disease in women: risks and benefits of hormone therapy, Sex-Specific Effects of Endocrine Disruption on Aging and Alzheimer's Disease, Yale University Clinical and Translational Science Award Program, Mayo Clinic Center for Translational Science Activities, Yale Clinical and Translational Science Award
OpenAlex ID: W3083655604