[Effect of hormone replacement therapy during the climacteric on cerebrovascular diseases]

Abstract

In epidemiological and animal studies it could be shown that a hormone replacement therapy decreased the risk of stroke. Sonographical blood flow measurement shows a positive effects to the cerebrovascular system caused by estrogen which was not modified by gestagens. In morphometric investigations by sonographical measurements of intima-media-thickness, it could be demonstrated that a positive influence by hormone replacement therapy can be achieved for a longer time. The intima-media-thickness, as a sign of a complex atherosclerosis, is decreased. The number of atherosclerotic plaques is significantly lower in patients receiving hormone replacement therapy (HRT) in comparison to a control group. A regression of the plaques by estrogen replacement therapy could be shown in one study. Although the group of patients suffering from stroke is heterogeneous, the benefit of HRT for prevention of cerebrovascular diseases could clearly be demonstrated. HRT is not contraindicated in patients suffering from cerebrovascular diseases. In most of cases, HRT is recommended in these patients. The therapeutic effect of HRT for cerebrovascular disease should be proved in further prospective studies.