HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stevenson, J. C Search for Related Content PubMed Articles by Stevenson, J. C

Hormone replacement therapy and cardiovascular disease

Reader in Metabolic Medicine and Consultant Physician, National Heart and Lung Division, Faculty of Medicine, Imperial College London, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. email: j.stevenson{at}imperial.ac.uk

Observational studies of hormone replacement therapy show coronary heart disease benefit, whereas randomised clinical trials do not. In the latter, this is perhaps because early harm caused by hormone replacement therapy outweighs any later benefit. Early harm may be caused by inappropriately high starting doses for the woman's age, which could cause transient increases in thrombogenesis and adverse vascular remodelling. Later benefit could result from oestrogen action on metabolic risk factors, as well as direct arterial effects reducing atherogenesis. Women in observational studies are younger and starting doses are appropriate for their age. Hormone replacement therapy doses and regimens that benefit coronary heart disease could be formulated and tested.

Keywords Keywords / coronary heart disease / hormone replacement therapy / metabolic factors / thrombogenesis / vascular remodelling