Coronary heart disease prevention in menopausal women

During the last 20 years, cardiovascular mortality has steadily declined in men. Concurrently, cardiovascular death rates have remained stable in women. Prior to the availability of randomised, controlled trial results, postmenopausal hormonal therapy was believed to confer cardiac protection. Now that these trials have been completed, it is clear that oestrogen is not effective for coronary prevention; consequently, other pharmacological and non-pharmacologic interventions must be invoked to reduce coronary risk. This paper discusses the impact of menopause on conventional risk factors and reviews gender-specific primordial, primary and secondary prevention strategies.