Raloxifene slows down the progression of intima-media thickness in postmenopausal women

OBJECTIVE: To investigate the effect of raloxifene on atherosclerosis progression in healthy postmenopausal women. DESIGN: In a prospective fashion, a total of 155 healthy postmenopausal women were randomly assigned to receive raloxifene 60 mg/day or a matching placebo for 18 months. Atherosclerosis progression was evaluated by B-mode ultrasonography measuring the intima-media thickness (IMT) of the carotid arteries. Plasma levels of triglycerides, low-density lipoprotein cholesterol, soluble forms of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1, E-selectin, interleukin-6, tumor necrosis factor alpha, adiponectin, and the degree of insulin resistance by the homeostatic model assessment method were also determined. RESULTS: The progression slope of carotid IMT was 0.0112 mm/18 months in the raloxifene group and 0.0857 mm/18 months in the placebo group (P<0.004). Raloxifene treatment compared with placebo produced a significant decrease in plasma triglycerides (P<0.02), low-density lipoprotein cholesterol (P<0.02), soluble forms of intercellular adhesion molecule-1 (P<0.005) and vascular cell adhesion molecule-1 (P<0.04), E-selectin (P<0.02), interleukin-6 (P<0.005), tumor necrosis factor alpha (P<0.005) levels, and homeostatic model assessment index (P<0.005) and a significant increase in plasma adiponectin levels (P<0.001). Logistic regression analysis indicated that women receiving raloxifene had a lower risk of IMT progression (odds ratio=0.41; 95% CI: 0.32-0.70). CONCLUSION: Raloxifene treatment, possibly through an increase in plasma adiponectin levels, may slow the progression of IMT in postmenopausal women.