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Hormone replacement therapy and cardiovascular disease
Insights
Estrogen replacement therapy significantly reduces cardiovascular disease risk in postmenopausal women. Hormone replacement therapy, including progestogens, appears safe for cardiovascular protection, warranting further research.
Area of Science:
- Cardiology
- Endocrinology
- Women's Health
Background:
- Coronary heart disease (CHD) is a leading cause of mortality in postmenopausal women.
- These women exhibit an increased cardiovascular risk profile, including android obesity, hyperinsulinemia, impaired glucose tolerance, insulin resistance, and dyslipidemia (elevated LDL, VLDL, triglycerides, and lipoprotein (a)).
Purpose of the Study:
- To review the existing literature on hormone replacement therapy (HRT) and its impact on cardiovascular disease (CVD) risk in postmenopausal women.
- To make recommendations for future clinical practice and research.
Main Methods:
- A comprehensive literature review was conducted.
- Evidence regarding the cardiovascular effects of estrogen replacement therapy (ERT) and combined hormone replacement therapy (HRT) was analyzed.
Main Results:
- Estrogen replacement therapy (ERT) demonstrates a significant reduction in the relative risk of cardiovascular disease.
- The inclusion of progestogens in HRT regimens, based on current evidence, does not appear to negatively impact cardiovascular protection.
Conclusions:
- Estrogen replacement therapy offers significant cardiovascular benefits for postmenopausal women.
- Current evidence suggests HRT with progestogens is safe concerning cardiovascular protection, but further investigation is recommended.
Abstract:
Coronary heart disease is the principal cause of death in postmenopausal women. Postmenopausal women have an elevated cardiovascular risk profile in the form of android obesity (increased waist/hip ratio), hyperinsulinemia, impaired glucose tolerance, increased insulin resistance and elevated plasma LDL, VLDL, serum triglyceride and lipoprotein (a). A significant decrease in the relative risk of cardiovascular disease is observed with estrogen replacement therapy. The addition of progestogens commonly used in hormone replacement regimes does not, based on present evidence, seem to affect cardiovascular protection adversely. The literature on this subject has been reviewed and recommendations made with implications for the future.