Maturitas 49 (2004) 253–263 The effects of 17-oestradiol plus dydrogesterone compared with conjugated equine oestrogens plus medroxyprogesterone acetate on lipids, apolipoproteins and lipoprotein(a) Alyde T. de Kraker a , Peter Kenemans b , Raimond G.V. Smolders b , Maurice V.A.M. Kroeks a , Marius J. van der Mooren b,∗ a Project ‘Ageing Women’, Departments of Obstetrics and Gynaecology, Diakonessenhuis Utrecht, VU University Medical Center Amsterdam, The Netherlands b Departments of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands Received 8 March 2004; received in revised form 21 May 2004; accepted 24 May 2004 Abstract Objective: To compare the effects of 17-oestradiol plus dydrogesterone with conjugated equine oestrogens plus medrox- yprogesterone acetate on serum lipids, apolipoproteins and lipoprotein(a) in postmenopausal women. Methods: A multi-centre, prospective, randomised, double-blind, comparative one-year study in 362 healthy postmenopausal women aged 39–74 years with an intact uterus. Fasting blood samples were taken at baseline and after 28 and 52 weeks of treatment. Participants received daily oral treatment with continuous combined 1 mg micronised 17-oestradiol/5 mg dydrogesterone (E/D: n = 180) or 0.625 mg conjugated equine oestrogens/5 mg medroxyprogesterone acetate (CEE/MPA: n = 182). Results: Significant differences between the two groups after 52 weeks were observed for total cholesterol (E/D: -1.7%; CEE/MPA: -7.3%), LDL-cholesterol (E/D: -4.5%; CEE/MPA: -11.3%), HDL-cholesterol (E/D: +15.3%; CEE/MPA: +7.5%), triglycerides (E/D: +9.8%; CEE/MPA: +16.6%), VLDL-triglycerides (E/D: -3.3%; CEE/MPA: +10.0%), lipoprotein(a) (E/D: 0.0%; CEE/MPA: -25.2%) and for the ratio apolipoprotein B/LDL-cholesterol (E/D: +0.9%; CEE/MPA +5.9%). Conclusions: E/D and CEE/MPA differ in their anti-atherogenic effects on lipids and lipoproteins. This however can not easily be translated to differences in clinical cardiovas- cular outcomes. © 2004 Elsevier Ireland Ltd. All rights reserved. Keywords: Menopause; Lipids; Apolipoproteins; Lipoprotein(a); Oestradiol; Dydrogesterone; Conjugated equine oestrogens; Medroxyprogesterone acetate ∗ Corresponding author. Tel.: +31 20 4443244; fax: +31 20 4444422. E-mail address: mj.vandermooren@vumc.nl (M.J. van der Mooren). 1. Introduction Cardiovascular disease is the most common cause of morbidity and mortality in men and women in de- veloped countries. Although, the incidence increases with age in both sexes, in women the risk increases markedly after the menopause [1]. The Nurses’ 0378-5122/$ – see front matter © 2004 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.maturitas.2004.05.006