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Hormone replacement therapy and cardiovascular risk.

M Gerhard-Herman¹, N Hamburg, P Ganz

¹Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, L2-015, Boston, MA 02115, USA. mgerhard@partners.org

Current Cardiology Reports

|August 23, 2000

Summary

Hormone replacement therapy (HRT) did not reduce cardiovascular events in postmenopausal women with existing heart disease, contrary to prior beliefs. This study reevaluates HRT

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Area of Science:

Cardiovascular Science
Endocrinology
Clinical Trials

Background:

Estrogen replacement therapy was previously thought to offer significant cardioprotection based on laboratory and observational studies.
The Heart and Estrogen/Progestin Replacement Study (HERS) trial provided initial randomized data on HRT in postmenopausal women with coronary artery disease.

Purpose of the Study:

To reexamine the role of hormone replacement therapy (HRT) in cardiovascular risk.
To reassess the underlying basic science of HRT's cardiovascular effects in light of new trial data.

Main Methods:

Analysis of results from the Heart and Estrogen/Progestin Replacement Study (HERS) trial.
Review of recent evidence concerning thromboembolic risk, inflammation, and different types of HRT.

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Main Results:

The HERS trial, a randomized trial, did not demonstrate a reduction in cardiovascular events for postmenopausal women with coronary artery disease receiving HRT.
These findings challenge the previously assumed cardioprotective role of HRT.

Conclusions:

The HERS trial results necessitate a reevaluation of the cardiovascular effects of hormone replacement therapy.
Further investigation into thromboembolic risk, inflammation, and specific HRT formulations is warranted.