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Background: Fluctuations in lipid and lipoprotein levels are encountered quite often in hyperlipidemic patients. We examined the possibility that lipid and lipoprotein levels fluctuate due to the different effects of estrogen and progestogen in postmenopausal hyperlipidemic women receiving combined hormonal replacement therapy. Methods: In an open-label study conducted during 3 consecutive hormonal cycles (3 months), levels of fasting total cholesterol, triglycerides, and low (LDLC)- and high-density lipoprotein cholesterol (HDLC) were determined in 36 postmenopausal hyperlipidemic women on day 13 of conjugated equine estrogen (1.25 mg/d) therapy and on day 25 after 12 days of receiving estrogen plus medroxyprogesterone acetate (5 mg/d). Results: While receiving estrogen and combined therapies, means [+ or -] SD total cholesterol levels increased from 6.50 [+ or -] 0.97 mmol/L (251 [+ or -] 37 mg/dL) to 6.88 [+ or -] 1.42 mmol/L (266 [+ or -] 54 mg/dL) (P [is less than] .001); LDLC levels, from 4.05 [+ or -] 1.14 mmol/L (156 [+ or -] 44 mg/dL) to 4.62 [+ or -] 1.36 mmol/L (178 [+ or -] 52 mg/dL) (P [is less than] .001). Mean [+ or -] SD HDLC cholesterol levels decreased from 1.44 [+ or -] 0.32 mmol/L (55 [+ or -] 12 mg/dL) to 1.29 [+ or -] 0.28 mmol/L (50 [+ or -] 10 mg/dL) (P [is less than] .001); triglyceride levels, from 2.23 [+ or -] 1.03 mmol/L (197 [+ or -] 91 mg/dL) to 2.06 [+ or -] 1.04 mmol/L (182 [+ or -] 92 mg/dL) (P [is less than] .001). Conclusions: Hyperlipidemic postmenopausal women receiving combined sequential estrogen and progestogen replacement therapy demonstrate very significant fluctuations in their lipid and lipoprotein levels. These fluctuations depend on the hormonal phase, ie, estrogen alone or combined with progestogen. Arch Intern Med. 1998;158:1803-1806

Abstract Objective--To test the hypothesis that subjects who clear chylomicron remnants slowly from plasma may be at higher risk of coronary artery disease than indicated by their fasting plasma lipid [...]

The effects of plasma lipids on the clinical and angiographic parameters of 134 patients, in whom coronary angioplasty was in 157 vessels, were prospectively examined. During a 6-month follow-up, restenosis was detected angiographically in 39 patients (29%; 45 vessels). None of the clinical, biochemical, or angiographic variables examined was predictive of stenosis and the tendency of a vessel to restenose was not patient-dependent but rather lesion-related. However, restenosis developed in 31 of 102 vessels (300A) in patients with high-density lipoprotein (HDL) cholesterol [less than or equal to] 40 mg/dl, compared with restenosis in 10 of 55 vessels (19%) in patients with HDL cholesterol >40 mg/dl (p = 0.092). No significant differences were observed when restenosis rates were compared in patients with total cholesterol levels >250 mg/dl or 160 mg/dl and