[Hormonal supplement therapy in women: effects on the cardiovascular system]

Coronary heart disease develops on average 10-15 years later in women than in men and is uncommon before menopause. 17 beta-estradiol has atheroprotective properties through rapid vasodilatory effects on the endothelium by stimulating nitric monoxide production and longer-term actions by modulating changes in gene expression. Cardioprotective effects of hormone replacement therapy in postmenopausal women have been suggested by observational data but not proved in randomized trials. Recent data indicate that oestrogens have regenerative effects on the vascular wall after acute injury, like a percutaneous transluminal coronary angioplasty. As endothelial reactivity declines with age, more studies are needed to investigate the benefits of hormone replacement therapy in the younger category of postmenopausal women.