ASSOCIATION OF HORMONE REPLACEMENT THERAPY IN POST MENPOSALWOMEN AND CARDIOVASCULAR DISEASE
Hormone replacement therapy (HRT) has been used for more than 60 years to treat menopausal estrogen deficiency and increase longevity in postmenopausal women. However, following the publication of the Women’s Health Initiative (WHI) study, the effect of HRT on cardiovascular risk has been the subject of much debate. The initial findings of this study demonstrated an increased risk of coronary heart disease (CHD) in older women, without increasing mortality.
Hormone replacement therapy (HRT) has a profound impact on the cardiovascular system in postmenopausal women, achieved through its effects on metabolic risk factors for coronary heart disease (CHD) and on arterial function. Observational studies have consistently shown an association between postmenopausal HRT use and a reduced incidence of CHD. However, the largest randomized trial initially reported no overall benefit on CHD risk. Subsequent analyses and follow-up of the study have demonstrated a significant benefit for CHD risk in healthy women initiating estrogen therapy soon after the onset of menopause. This benefit of early initiation of HRT has been confirmed in more recent trials. The dose and type of hormones at initiation of therapy appears crucial to obtaining CHD benefit.