Risk Factors in Postmenopausal Therapy

To the Editor.—  In the article by Barrett-Connor and associates (241:2167, 1979) on heart risk factors in postmenopausal women receiving estrogen, a paradox is noted in that both lack of estrogen and estrogen therapy cause an increase in levels of blood triglycerides. One explanation for elevated triglyceride levels in women taking estrogen is that a high intake of sucrose apparently aggravates the effect of estrogen on triglyceride production.¹ Gonane progesterone use concomitantly with estrogen decreases the effect of estrogen on triglyceride (and cholesterol) blood levels.² This, in judging the reason for increased blood triglycerides in the group of women described by Barrett-Connor et al, an accounting of sucrose intake and progesterone use would be helpful in interpreting the paradoxical findings.The authors imply that use of estrogen in postmenopausal women may give significant cardiovascular benefits that outweigh the increased risk of endometrial cancer. Since progesterone use along with