[Secondary prevention in coronary diseases. Viewpoint of the gynecological endocrinologist]

Although reduction of cardiovascular risk by estrogen substitution in the menopause has not been proven by a prospective randomized study the results of the present epidemiologic studies with the most various methodological approaches leave hardly any doubt about such a protective effect. Furthermore the published data show that women with cardiovascular risk factors or with a preexisting cardiovascular disease benefit more from estrogen substitution than healthy women. Addition of gestagen in non hysterectomized women for the reduction of increased risk for endometrial cancer seems to impair the benefit for cardiovascular risk only minimally if at all.