ORIGINAL ARTICLE Short-term effect of tibolone on C-reactive protein in hypertensive postmenopausal women Yaprak Engin-U ¨ stu ¨n Æ Yusuf U ¨ stu ¨n Æ Ilgın Tu ¨rkc ¸u ¨og ˘lu Æ M. Mutlu Meydanlı Æ Ays ¸e Kafkaslı Æ Gu ¨ lay Yetkin Received: 21 July 2007 / Accepted: 3 June 2008 / Published online: 27 June 2008 Ó Springer-Verlag 2008 Abstract Objective To evaluate the effects of tibolone on the serum C-reactive protein (CRP) in hypertensive postmen- opausal women. Methods We enrolled 45 postmenopausal patients with hypertension and 17 normotensive postmenopausal women. Inclusion criteria were surgical menopause, the presence of vasomotor symptoms, and normal mammo- gram within 1 year, the absence of documented coronary artery disease, and normal electrocardiography. Forty hypertensive women and 17 normotensive women com- pleted the 3-month period. Twenty-one hypertensive women received tibolone, whereas 19 served as control. At baseline and at 3 months, blood lipids and CRP were evaluated. Results Changes in lipid profile and CRP in the hyper- tensive and normotensive control groups during 3 months were not statistically significant. Total cholesterol levels decreased significantly after 3 months of tibolone treat- ment. A significant increase in CRP values was observed in the tibolone group (p = 0.001). Conclusion This trial demonstrated that tibolone treat- ment induced a significant increase in CRP and a significant decrease in total cholesterol in postmenopausal hypertensive women. Keywords Menopause  Hypertension  Tibolone  C-reactive protein Introduction Patients with hypertension are at increased risk of coronary artery disease and cardiovascular morbidity and mortality increase after menopause, and hence identification and treatment of additional risk factors are important in the postmenopausal hypertensive group. The effects of post- menopausal hormone therapy on cardiovascular risk markers vary according to the formulation and route of administration, with oral estrogen therapy being the most extensively studied [5]. Tibolone, a synthetic steroid with tissue-specific estro- genic, progestogenic, and androgenic properties, is being increasingly used in healthy postmenopausal women [10]. Clinical endpoint data for cardiovascular events from ran- domized controlled trials are currently not available for tibolone [10]. Tibolone may enhance cardioprotection by favorably modulating lipids-lipoproteins [4]. Numerous studies have demonstrated a reduction in high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 levels with tibolone therapy [1, 3, 8]. Decreases in total cholesterol, triglycerides, and very low-density lipoprotein- cholesterol (VLDL-C) levels have also been reported, although this is not a consistent finding [3]. There is increasing evidence that high sensitivity C-reactive protein (CRP) may be an independent risk marker for cardiovascular disease or may have some direct proinflammatory and atherogenic properties. C-reactive The part of this manuscript was published in the supplement of Archives of Gynecology and Obstetrics 2007;275(suppl 1):163–164. Y. Engin-U ¨ stu ¨n (&)  Y. U ¨ stu ¨n  I. Tu ¨rkc ¸u ¨og ˘lu  M. Mutlu Meydanlı  A. Kafkaslı Department of Obstetrics and Gynecology, School of Medicine, Inonu University, Kadın Hastalıkları ve Dog ˘um AD, 44069 Malatya, Turkey e-mail: ustunyaprak@yahoo.com G. Yetkin Department of Microbiology, School of Medicine, Inonu University, Malatya, Turkey 123 Arch Gynecol Obstet (2009) 279:305–309 DOI 10.1007/s00404-008-0712-6