Hormone Replacement and Cardiovascular Disease in Older Women

Abstract

Estrogen replacement therapy is increasingly being proposed as a means of reducing cardiovascular disease in postmenopausal women, but controlled clinical trials with definitive cardiovascular and noncardiovascular outcomes have not been completed. Users of estrogen replacement therapy have been shown repeatedly to have better cardiovascular disease risk factor profiles than nonusers, but much of this reduced risk may be due to the higher socioeconomic status, better medical care, and heightened health consciousness common to hormone users. Still, potential benefits of postmenopausal hormone use are great. Provided that such benefits are not outweighed by adverse effects (such as thrombosis, breast cancer, and endometrial cancer), estrogen replacement therapy offers hope of substantial reductions of cardiovascular disease risk in middle-aged and older postmenopausal women.