Background: Cardiovascular diseases (CVDs) are the leading cause of death worldwide, particularly affecting men and postmenopausal women, where estrogen loss may elevate risk. Hormone replacement therapy (HRT) initially emerged as a potential intervention for CVD risk reduction in the 1970s; however, recent findings advise against HRT for CVD prevention, favouring its limited use for menopausal symptoms. Selective estrogen receptor modulators (SERMs), such as raloxifene, offer a targeted approach by improving lipid profiles without stimulating breast or uterine tissues.
Aim of the study: The study aims to identify and analyze the key cardiovascular risk determinants in postmenopausal women using raloxifene.
Methods: This prospective, case-control study at Bangladesh Medical University in Dhaka included 160 postmenopausal women divided into an osteoporosis group (80 women on daily raloxifene 60 mg) and a control group (80 healthy women advised on diet and exercise). Inclusion required over two years of amenorrhea, while exclusion criteria ruled out systemic diseases, cardiovascular conditions, and recent hormone treatments. Baseline assessments included gynaecological exams, DEXA, mammography, and biochemical markers for cardiovascular risk, measured at baseline and after 12 months. Data were analyzed using SPSS, with a p-value ? 0.05 indicating statistical significance.
Result: This study focused on postmenopausal women, with a mean age of 58.84 years in cases and 59.19 years in controls. Both groups had similar menopause durations, mostly natural, and BMI and blood pressure were closely matched. After one year of treatment, the case group showed significant improvements in total cholesterol (222.73 to 198.82 mg/dl, P<0.001), LDL (136.96 to 120.55 mg/dl, P=0.002), Apo A, fibrinogen, and homocysteine levels. Triglycerides and HDL remained stable. The control group had no significant lipid changes, but carotid intima-media thickness increased (P=0.043), indicating vascular changes were absent in the case group.
Conclusion: This study found that raloxifene significantly reduced cardiovascular risk factors in postmenopausal women, including total cholesterol, LDL, homocysteine, and fibrinogen. Unlike controls, the raloxifene group did not show progression in carotid intima-media thickness, indicating potential arterial health protection. These results support raloxifene’s role in cardiovascular risk reduction, warranting further study.
International Journal of Clinical Obstetrics and Gynaecology
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