Hormone replacement therapy and cardiovascular disease

摘要

Replacement of estrogen is effective for relief of perimenopausal symptoms. This principle indication appears not to be in conflict with data indicating an increased cardiovascular burden in women of higher age or symptomatic cardiovascular disease. Classical risk factors for cardiovascular disease emerge long before estrogen declines. Thus, the deprivation of estrogen cannot be solely responsible for the increasing risk of atherosclerotic artery disease in postmenopause Socioeconomic status has a decisive impact on cardiovascular risk and correlates with the use of HRT. This healthy user effect implies no cardiovascular risk provided there is appropriate health care. The increased risk for vascular events in HERS and WHI may only apply to women with clinical or subclinical arteriosclerosis. The unique finding of an overall increased risk for cardiovascular events in the WHI does not apply to the subgroup of women within the first 10 years of postmenopause or those suffering from hot flushes.In essence, HRT can be used for relief of perimenopausal symptoms, but HRT cannot compensate for deficits in the individual lifestyle and health care Certainly, a healthy lifestyle and good medical care are the basis for preventing cardiovascular disease.