Hormone Therapy and the Primary and Secondary Prevention of Cardiovascular Disease
The publication of the first results from the Heart and Oestrogen/progestin Replacement Study (HERS)(1) led to a turmoil in the perception of cardioprotection by hormone replacement therapy (HRT). Basically, the study showed that a continuous combined regimen (conjugated equine estrogen/medroxyprogesterone acetate) in women with documented coronary artery disease (CAD) was associated with higher mortality than in a placebo group during the first year of treatment. Later on this ill-effect was reversed and at years 4+5 of the study, the known benefit of HRT became evident. The possibility that HRT might be dangerous in prevention of CAD has been discussed quite extensively since the announcement of the HERS trial results. Questions like: “Are these findings really true? Can we extrapolate those results to the general postmenopausal population?” are presented in every forum on HRT. The following chapter will review the relevant data and discuss the various aspects of one of the most important issues in menopause medicine — cardioprotection by HRT.
KeywordsPostmenopausal Woman Honnone Replacement Therapy Estrogen Replacement Therapy Preventive Cardiology Documented Coronary Artery Disease
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