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Menopausal Hormone Therapy

Is There Evidence for Cardiac Protection?

  • Chapter
Book cover Coronary Disease in Women

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Several converging variables have escalated the interest in menopausal hormone therapy as a unique cardioprotective mechanism for women. These variables include the progressive aging of the population, with women enjoying an increased life expectancy and spending a greater proportion of their lives in the menopausal state; the predominance of clinical coronary events in menopausal women; the excess coronary risk in women with premature menopause or bilateral oophorectomy, which is abolished by estrogen therapy (1); and the less favorable outcomes of women than their male counterparts with myocardial infarction (MI) and coronary revascularization procedures, which underscore the need for better preventive strategies (2). Furthermore, an array of biologically plausible mechanisms for estrogen-mediated cardioprotection is evident (3), and a sizeable compendium of data from observational studies of estrogen use suggests that it might help prevent cardiovascular disease (CVD) in healthy women and curtail illness progression in women with coronary heart disease (CHD). Only recently has information regarding menopausal hormone therapy and cardiovascular outcomes been derived from randomized controlled clinical trials (RCTs). Overwhelmingly conflicted with the traditional assumptions of benefit, this evidence has guided contemporary position papers and scientific statements from professional health organizations. Each of these aspects is examined.

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  1. Nanette K. Wenger MD
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  1. Outcomes Research, American Cardiovascular Research Institute, Atlanta, GA, USA

    Leslee J. Shaw PhD

  2. Division of Cardiology, University of California School of Medicine, San Francisco, CA, USA

    Rita F. Redberg MD, FACC

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Wenger, N.K. (2004). Menopausal Hormone Therapy. In: Shaw, L.J., Redberg, R.F. (eds) Coronary Disease in Women. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-645-4_21

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  • DOI: https://doi.org/10.1007/978-1-59259-645-4_21

  • Publisher Name: Humana Press, Totowa, NJ

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