Hormone Replacement Therapy in Hypertensive, Postmenopausal Women: Role of the Gynecologist

Abstract

Postmenopausal women represent the largest category of women who are at risk for hypertension and coronary heart disease (CHD). The risk for CHD is not only due to the rise in lipid risk factors with age, but also because of the rise of other risk factors, most notably hypertension and diabetes with age. After menopause, the incidence of hypertension, cardiovascular disease and cardiovascular mortality increases progressively in women relative to men leading to an eventual equal incidence in both sexes. Most untreated women with hypertension will develop further increases in their arterial pressure with time. The most frequent cause of death among U.S. women is cardiovascular disease leading to approximately 250 000 deaths per year. This is approximately double the cancer mortality rate in women and six times that for breast cancer (44 000 deaths in 1992).