Lege Artis Medicinae

[CARDIOVASCULAR EFFECTS OF MENOPAUSAL HORMONE REPLACEMENT THERAPY]

PARAGH György, HARANGI Mariann

MARCH 21, 2006

Lege Artis Medicinae - 2006;16(03)

[The incidence of coronary heart disease in women rises sharply in the years following menopause. Hormone replacement therapy involves the administration of oestrogen, which provides postmenopausal symptom relief and reverses the changes in calcium and lipid metabolism. Moreover, oestrogen is also postulated to engage multiple mechanisms that defend against hypertension. Early observations suggested that postmenopausal women treated with hormone replacement therapy have significantly reduced cardiovascular risk. However, the results of primary and secondary prevention randomized clinical trials confirmed an increased cardiovascular risk rather than a beneficial effect of hormone replacement therapy in highrisk women. Controversy between results of observational and randomized clinical trials may partly be due to the unexplored genetic background. The authors summarize the effects of oestrogen on lipids, inflammation, haemostatic parameters, blood pressure and vascular wall. Genetic factors that modulate the effect of oestrogen as well as current recommendations on hormone replacement therapy after menopause in high risk women are also presented.]

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