Hormones, Women, and Cardiovascular DiseasePrimary vs. Secondary Prevention after Menopause

摘要

NA;Hormone replacement therapy lpar;HRTrpar; may provide greater benefits or risks to women after menopause depending on the patient's clinical history. This review focuses on the effects of HRT on primary vs. secondary prevention of cardiovascular disease. For women without known cardiovascular disease, HRT may reduce risk through improvement in lipids, cardiac contractility, and body composition. The improvement in vasodilatation with estrogen may be diluted by the addition of a progestin. The effects of HRT on coagulation and vascular inflammation are more difficult to interpret. For women with known disease, HRT may reduce subclinical atherosclerosis and increase longhyphen;term survival after coronary artery bypass grafting. However, it may not prevent subsequent cardiac events and may increase the shorthyphen;term risk of thrombosis for these patients. Understanding the risks and benefits of HRT relative to cardiovascular history should allow physicians to provide useful information to patients.The Endocrinologist 2000semi; 10colon; 113hyphen;117Learning Objectivescolon;How might hormone replacement therapy lpar;HRTrpar; be an effective primary strategy to prevent cardiovascular disease lpar;CVDrpar;quest;Contrast the effects of HRT on CVD risk factors in postmenopausal women with and without known CVDBased on recent clinical trials, what advice is appropriate to offer women with or without CVD with respect to taking HRTquest;