Hormone replacement therapy and coronary heart disease in women: a review of the evidence
Autor: | Jinna M. Shepherd, Honey E. Holman, C. Andrew Brown, G. Swink Hicks, Annette K. Low, Lori D. Russell |
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Rok vydání: | 2002 |
Předmět: |
Gynecology
medicine.medical_specialty Clinical Trials as Topic Time Factors business.industry medicine.drug_class Hormone Replacement Therapy Incidence (epidemiology) medicine.medical_treatment Hormone replacement therapy (menopause) Coronary Disease Estrogens General Medicine Clinical trial Postmenopause Estrogen Internal medicine Epidemiology Medicine Humans Observational study Female business Progestin Cause of death |
Zdroj: | The American journal of the medical sciences. 324(4) |
ISSN: | 0002-9629 |
Popis: | It is well documented that coronary heart disease (CHD) is the leading cause of death in women-especially postmenopausal women. The role of hormone replacement therapy (HRT) in prevention of CHD has been considered for many years. Early epidemiological studies suggested estrogen to have a potential cardioprotective role, noting that premenopausal women have a decreased risk of developing CHD compared with men. Later observational studies showed decrease of CHD risk in postmenopausal women on HRT. By 1996, estrogen (specifically Premarin) was one of the most dispensed medications in the United States. Major medical organizations such as the American College of Physicians and American College of Obstetricians and Gynecologists widely endorsed and encouraged HRT for CHD risk reduction, along with using HRT for other potential benefits (such as osteoporosis prevention). Unfortunately, recent clinical trials seem to raise more questions than provide definitive proof in the protective role of estrogen in CHD. A review of recent and ongoing observational studies and clinical trials may help guide physicians in their recommendation and discussion of the role of HRT in postmenopausal women. As this article was being prepared for publication, reports from both the Heart and Estrogen/Progestin Replacement Study Follow-up (HERS II) and the Women's Health Initiative (WHI) were published. Both studies concluded that HRT has no role in primary or secondary prevention of CHD in women. |
Databáze: | OpenAIRE |
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