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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:1669.)
© 2007 American Heart Association, Inc.

Editorials

Hormone Replacement Therapy and Atherosclerosis in Postmenopausal Women

Does Aging Limit Therapeutic Benefits?

Matthias Barton; Matthias R. Meyer; Elvira Haas

From the Department of Internal Medicine, Internal Medicine I, Medical Policlinic, University Hospital Zurich, Switzerland.

Correspondence to Matthias Barton, MD, University Hospital Zurich, Department of Internal Medicine, Internal Medicine I, Medical Policlinic, Rämistrasse 100, CH-8091 Zürich, Switzerland. E-mail barton@usz.ch

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Despite the clear-cut epidemiological evidence of protective effects of endogenous estrogens in premenopausal women,^1,2 the results of randomized clinical trials using conjugated equine estrogens and medroxyprogesterone acetate instead of natural hormones have led to a paradigm shift in the usefulness of hormone treatment in postmenopausal women.^3,4 One of the main criticisms in addition to the types of drugs chosen for treatment was the age of the patients. Indeed, in both WHI trial and HERS study, treatment of patients was initiated in women many years beyond menopause.⁵ In fact, the number of years since menopause was an independent indicator for nonfatal myocardial infarction or coronary related death.⁵ In this context, it appears of interest that heart disease may contribute to menopausal age and that menopausal age actually may be an indicator of cardiovascular risk.^6,7

See page 1782

It was noted as early as 1952 that the natural endogenous estrogen 17ß-estradiol inhibits experimental atherosclerosis,⁸ and oral estrogens were even unsuccessfully evaluated to treat coronary artery disease in male patients.^9–11 However, at the time little was known about the mechanisms by which sex steroid hormones affect vascular homeostasis and thrombogenesis. During the past 2 decades, considerable advances were made in the understanding of how natural estrogens act on the vasculature. 17ß-estradiol causes rapid and endothelium-independent dilation of coronary arteries of men and women,¹² and chronic treatment with 17ß-estradiol inhibits experimental atherosclerosis in males and females.^13,14 On the other hand, treatment with conjugated equine estrogens, which contain more than 30 different steroid compounds including . . . [Full Text of this Article]

Related Article:

Age Moderates the Short-Term Effects of Transdermal 17ß-Estradiol on Endothelium-Dependent Vascular Function in Postmenopausal Women

Andrew Sherwood, Julie K. Bower, Judith McFetridge-Durdle, James A. Blumenthal, L. Kristin Newby, and Alan L. Hinderliter
Arterioscler Thromb Vasc Biol 2007 27: 1782-1787. [Abstract] [Full Text] [PDF]

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