Gregersen I, Høibraaten E, Holven KB, et al. – Researchers evaluated 140 postmenopausal women aged < 70 years in the Estrogen in Venous Thromboembolism Trial who were randomized to receive either active treatment (one tablet of 2-mg estradiol and 1 mg norethisterone acetate daily; n = 71) or placebo (n = 69) in order to investigate the impact of hormone replacement therapy (HRT) on the plasma atherogenicity in postmenopausal women. At 3 months, HRT compared with placebo significantly decreased plasma levels of Lp(a), ApoA1, ApoB, total cholesterol (TC), HDL-C, LDL-C, TC/HDL-C, and LDL-C/HDL-C ratio. No impact on ApoB/ApoA1 ratio or triglyceride levels was seen. The variation in Lp(a) was significantly and inversely related to the variation in estradiol and positively to the alterations in lipids, tissue factor pathway inhibitor activity and antigen, protein C, and fibrinogen. Overall, a robust impact of HRT on atherogenic lipids with a large decrease in the pro-thrombotic Lp(a) was validated in this study, suggesting an overall favorable impact on thrombogenicity following HRT in postmenopausal women at risk of venous thrombosis.