Since the first secondary prevention trials were published in 1998, the prospect of
hormone replacement therapy to prevent atherosclerotic heart disease in postmenopausal
women has changed dramatically. Early harmful effects of hormone replacement therapy
and lack of beneficial effects on coronary heart disease event rates in high-risk
women have challenged the beneficial results gleaned from observational studies in
the past. In this article, the effects of estrogens on lipids, hemostatic parameters,
inflammation, and the vascular wall are described. The discrepancies that have arisen
between the previous observational studies and recent randomized clinical trials are
discussed: The current available data indicate that estrogens are beneficial to healthy
endothelium but are harmful once atherosclerotic disease has developed.
KEYWORDS
Estrogen - atherosclerosis - hormone replacement therapy - coronary heart disease
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Angela H.E.M MaasM.D.
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