[Hormone replacement therapy and cardiovascular pathology in menopause]

Abstract

Although the incidence of vascular disease increases progressively with age, the increment observed in women between 50 and 60 years old does not seem to be directly correlated to the menopause. On the other hand, significant modifications of some risk factors, particularly those related to lipid metabolism and the hemostatic system have been observed in postmenopausal women. It should be stressed that the results of these studies, although generally concordant, cannot be applied directly to the entire population: the majority of women studied were well-educated and from the upper-middle social and economic classes and thus more prone to comply with behavioral and therapeutic precepts. Moreover, non-white women were excluded from these studies. At present, numerous data attest to the beneficial effect of hormone replacement therapy on cardiovascular disease in postmenopausal women. The presently running National Institutes of Health 9-year randomized primary prevention study (Women's Health Initiative) and the secondary prevention "Heart Estrogen/Progestin Replacement Study" should, within a few years, provide further and, it is hoped, definitive information concerning the utility of hormone replacement therapy for the primary and secondary prevention of cardiovascular disease.