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Can a Lifestyle Intervention Attenuate the Effect of Discontinuing Hormone Therapy on CVD Risk Factors?: 1518Board #8 May 30 3:30 PM 5:00 PM

Pettee, Kelley K.; Kriska, Andrea M. FACSM; Conroy, Molly B.; Johnson, B. Delia; Orchard, Trevor J.; Goodpaster, Bret H.; Averbach, Frani M.; Kuller, Lewis H.

Medicine & Science in Sports & Exercise: May 2007 - Volume 39 - Issue 5 - p S231
doi: 10.1249/01.mss.0000273877.87578.11
B-20 Free Communication/Poster - Cardiovascular Disease Risk Factors: MAY 30, 2007 1:00 PM - 6:00 PM ROOM: Hall E

1Arizona State University, Mesa, AZ.

2University of Pittsburgh, Pittsburgh, PA.


Cardiovascular disease (CVD) continues to be the leading cause of death in postmenopausal (PM) women. Concern about the potential risks associated with hormone therapy (HT) has left women and heath care providers searching for safe and effective means for risk factor reduction.

PURPOSE: To determine the impact of a lifestyle intervention on CVD risk factors among women who were initially on HT at baseline and either continued or discontinued HT use at 18 months.

METHODS: The Woman On the Move through Activity and Nutrition (WOMAN) study is clinical trial designed to test whether a lifestyle intervention will reduce measures of subclinical CVD. Participants were randomized at baseline to either a health education (HE) or lifestyle change (LC) group. The impact the lifestyle intervention on CVD risk factors was examined in 240 PM [58.3 (2.9) years] women who either continued (n=110) or discontinued HT use (n=130) by 18 months.

RESULTS: The lifestyle intervention had a beneficial impact on CVD risk factor reduction. Compared to the HE group, women in the LC group had greater reductions in weight, BMI, and waist circumference (all p<0.0001). The LC group also significantly decreased insulin (p=0.04), improved saturated fat/cholesterol intake (p<0.0001), and increased leisure physical activity (p=0.005) levels. Both groups increased total cholesterol and LDL cholesterol (LDL-C) levels; however, the increases were significantly less in the LC group (p=0.02 and p=0.01, respectively). CVD risk factor changes were further explored by hormone therapy group, stratified by randomized group assignment. The HT group by randomized group interaction was statistically significant with regards to total cholesterol and LDL-C (both p=0.02). Within the HE arm, women who discontinued HT had significantly higher increases in total and LDL-C as compared to HT continuers (both p<0.01), whereas no such differences were observed in the LC arm.

CONCLUSIONS: A lifestyle intervention was effective for CVD risk factor reduction in PM women. Negative lipid consequences of discontinuing HT were noted only in the HE group and not among women randomized to the LC group. These findings suggest that a lifestyle behavioral approach can successfully attenuate increases in total cholesterol and LDL-C that result from HT discontinuation.

© 2007 American College of Sports Medicine