Assessing fatal cardiovascular disease risk with the SCORE (Systematic Coronary Risk Evaluation) scale in post-menopausal women 10 years after different hormone treatment regimens

Abstract

Objective. To assess fatal cardiovascular disease (FCD) risk among women in early post-menopausal years, as evaluated with the Systematic Coronary Risk Evaluation (SCORE) scale.

Design. This was a retrospective study of parallel cohorts. Two hundred seventy-three healthy post-menopausal women. Participants received one of the following hormone treatment (HT) regimens: transdermal estradiol (50 μg) (n = 99), sequential cyclic HT with transdermal estradiol (50 μg/day) plus 200 mg/day natural micronised oral progesterone (cycle days 12–25) (n = 63) and combined HT using transdermal estradiol (50 μg) plus 100 mg/day of micronised oral progesterone (n = 61). A group of women who elected not to use HT served as control group (n = 50). SCORE values were assessed before HT or follow up.

Results. Only one woman displayed a high-risk SCORE value both before and after 10 years of HT, the remaining had low risk values (<5%) for FCD. After 10 years, SCORE values increased significantly as compared to baseline among HT users (all three regimens) and controls. Although post-treatment SCORE values significantly differed among groups, values were all below the high risk cut-off (5%). There were no FCD events during the 10 year observation period.

Conclusion. As assessed with the SCORE scale, FCD risk in young post-menopausal women (HT users and controls) had a slight significant increase after 10 years, being values in the low risk range.

Keywords:

• Menopause
• fatal cardiovascular disease
• cardiovascular risk assessment
• hormone treatment
• SCORE scale
• transdermal estradiol
• progesterone

Acknowledgements

This research has been partially supported by the B/017543/08 AECID (‘Agencia Española de Cooperación Internacional para el Desarrollo’) grant from the Spanish ‘Ministerio de Asuntos Exteriores y Cooperación’.