Postmenopausal hormone replacement therapy and cardiovascular risk reduction. A review

Administration of unopposed postmenopausal estrogen therapy protects against coronary heart disease (CHD) in women. This is mediated, in part, through beneficial effects on lipid and lipoprotein metabolism. Fewer data are available with regard to CHD risk reduction when a progesterone is required in addition to estrogen. Administration of continuous, rather than cyclic, estrogen-progesterone therapy may maintain the beneficial effects of estrogen and yet protect against the increase in endometrial cancer observed with estrogen therapy alone. Clinical guidelines for hormone replacement therapy await the completion of adequate controlled clinical trials.