Hormone replacement therapy (estrogen and progesterone)

Is it necessary for heart disease prevention?

R. Freeman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

This is a brief review of the rationale for estrogen replacement as prevention of coronary artery disease. Epidemiological data suggest that premarin (0.625 mg) together with medroxyprogesterone acetate (2.5 mg) can prevent or delay the onset of coronary artery disease in postmenopausal women. The major effects of estrogens are: improving the lipid profile by lowering low density lipoprotein and raising high density lipoprotein; acting on vessel walls to reduce intimal damage and plaque formation; dilating vessels by both an endothelial dependent and an independent pathway; and acting as an antioxidant, thereby reducing the oxidation of low density lipoprotein and increasing the production of nitric oxide locally in the blood vessel. Oral estrogens and transdermal estrogens may act differently on coagulation factors and lipids. The role of specific estrogen receptor modulators as possible treatment for postmenopausal women in part will depend on the effect of these drugs in preventing coronary artery disease. The specific estrogen receptor modulators decrease low density lipoprotein and prevent triglyceride increases but it is unknown if they have estrogenic effects on blood vessel walls. Better compliance with estrogen replacement therapy will depend on educating women about their risk of getting coronary artery disease, and assisting them in decision making, as well as reducing side effects. The Heart and Estrogen/Progestin Replacement Study provides evidence that Prempro(TM) (Premarin/medroxyprogesterone acetate) should not be given to someone who already has heart disease without careful monitoring. (C) 2000 by CHF, Inc.

Original languageEnglish (US)
Pages (from-to)21-23+32
JournalPreventive Cardiology
Volume3
Issue number1
StatePublished - 2000

Fingerprint

Hormone Replacement Therapy
Estrogen Replacement Therapy
Progesterone
Coronary Artery Disease
Heart Diseases
Estrogens
Conjugated (USP) Estrogens
Medroxyprogesterone Acetate
Estrogen Receptor Modulators
LDL Lipoproteins
Blood Vessels
Tunica Intima
Lipids
Blood Coagulation Factors
Progestins
HDL Lipoproteins
Decision Making
Nitric Oxide
Antioxidants
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Public Health, Environmental and Occupational Health

Cite this

Hormone replacement therapy (estrogen and progesterone) : Is it necessary for heart disease prevention? / Freeman, R.

In: Preventive Cardiology, Vol. 3, No. 1, 2000, p. 21-23+32.

Research output: Contribution to journalArticle

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