Advancing Postmenopausal Preventive Therapy (APPT), a progestogen-free estrogen therapy to potentially reduce atherosclerosis: a randomized-controlled trial

Cardiovascular disease (narrowed or blocked blood vessels) is the leading cause of death, killing 1 of every 2 women. Atherosclerosis (hardening of the arteries) is the major cause of cardiovascular disease. More than 90% of deaths due to atherosclerosis occur after menopause when a women’s production of estrogen disappears. Research over the last decade has shown that estrogen provides potential cardiovascular benefits with low-risk to women. However, most women have a uterus that requires co-treatment with a progestogen (Provera, progesterone, etc.) to prevent thickening of the uterine lining due to estrogen. Compared to estrogen-alone therapy, traditional progestogen-estrogen therapy appears to have a greater health risk for women.   

The goal of this study is to learn whether a new type of progestogen-free hormone therapy, one that protects the uterus differently so that estrogen can be delivered without risk from progestogen, has beneficial effects on hardening of the arteries in postmenopausal women. Participants in the study will be randomized, split into two groups, to receive either an FDA-approved medication designed to deliver estrogen without a progestogen (Bazedoxifene /estrogen) or placebo, a pill that does not contain an active ingredient.  

Keywords: atherosclerosis, heart disease, menopause, women, estrogen, intervention