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Semin Vasc Med 2004; 4(2): 135-144
DOI: 10.1055/s-2004-835371
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

The Lost Promise of Hormone Replacement Therapy and Heart Disease

Angela H.E.M Maas1
  • 1Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands
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Publication History

Publication Date:
11 October 2004 (online)

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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. 

Dr. van Heesweg 2, 8025 AB Zwolle, The Netherlands