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Effect of hormone replacement therapy on cardiovascular disease: current opinion

Nusrat Shafiq Khan1, Samir Malhotra

  • 1Dept of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh City 160012, India. nusrat_shafiq@hotmail.com

Expert Opinion on Pharmacotherapy
|May 13, 2003
PubMed

Insights

Hormone replacement therapy (HRT) was once thought to reduce cardiovascular disease (CVD) risk in postmenopausal women due to oestrogen

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Women's Health

Background:

  • Cardiovascular disease (CVD) significantly impacts women, particularly postmenopause.
  • Declining oestrogen levels after menopause are linked to increased CVD incidence.
  • Oestrogen's known beneficial effects on lipid profiles and vascular tone suggested a protective role.

Purpose of the Study:

  • To evaluate the role of hormone replacement therapy (HRT) in cardiovascular disease (CVD) prevention in postmenopausal women.
  • To reconcile observational data with findings from recent large-scale clinical trials.

Main Methods:

  • Review of observational studies suggesting reduced CVD risk with HRT.
  • Analysis of evidence from major clinical trials including the Heart and Estrogen/Progesterone Replacement Study II, Estrogen Replacement and Atherosclerosis trial, and the Women's Health Initiative.

Main Results:

  • Observational studies indicated a cardiovascular benefit from HRT.
  • Key clinical trials (e.g., Women's Health Initiative) demonstrated no benefit of HRT for primary or secondary CVD prevention.
  • Recent evidence contradicts earlier findings on HRT's cardioprotective effects.

Conclusions:

  • Current evidence from major clinical trials does not support the use of HRT for CVD prevention in postmenopausal women.
  • Most health authorities no longer recommend HRT for preventing cardiovascular disease.
  • The perceived benefits of HRT for cardiovascular health in women are not supported by rigorous clinical trial data.

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