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P24 Background: There is evidence that estrogen affects the  vascular wall, independent of modifications to plasma lipoproteins, by  accelerating reendothelialization of damaged blood vessels and by  inhibiting smooth muscle cell proliferation. Therefore, we intended to  investigate the relationship between hormone replacement therapy (HRT)  use and prevalence of coronary calcium (CC) in postmenopausal women.  Methods: Cardiac electron beam computed tomography (EBCT) was performed  on 793 postmenopausal women participating in the Cedars-Sinai  Cardiovascular Observational Study. At the time of their EBCT, 509  women were receiving HRT and 284 were not receiving HRT. The total  coronary calcium score was determined using the Agatston method. A  self-report of HRT use was assessed in all participants, as well as  measurements of other known cardiovascular risk factors. Results:  Independent sample t-tests identified the means of the following  variables as significantly different between the two groups of women:  age, LDL, HDL, and BMI. Self reports of hypertension, smoking, exercise  and diet were similar between the two groups. Analysis of variance,  controlling for confounders, showed a significant difference (p&lt;.001)  between the marginal means (MM) of the two HRT groups for total  coronary calcium score, total number of calcified lesions, and total  volume of calcium. The MM total CC score was 96.40 (±256.39) for HRT  users and 150.97 (±362.54) for non-users. The MM number of lesions for  users was 2.16 (±3.37) and 3.36 (±4.75) for non-users. The MM volume  of calcium for users was 0.078 (±0.20) and 0.122 (±0.29) for  non-users. Conclusions: Total coronary calcium score, total lesions,  and total volume were found to be significantly lower in postmenopausal  women receiving HRT than for those not receiving HRT. These findings  support the hypothesis that hormone replacement therapy is associated  with a lower prevalence of coronary calcium in postmenopausal women,  which may be due to the independent effects of estrogen on coronary  vessel walls.

A Cross-Sectional Analysis of the Relationship Between Hormone Replacement Therapy and Coronary Artery Calcification