POSTMENOPAUSAL HORMONE-REPLACEMENT THERAPY AND CARDIOVASCULAR RISK

Case-control and cohort studies support the hypothesis that postmenopa usal oestrogen-replacement therapy reduces the risk of atherosclerotic disease manifeststions. The evidence for a cardioprotective effect of such a therapy is, however, incomplete because randomized prospective studies are missing, Because it may be almost impossible to conduct p lacebo-controlled trials in the future, other study designs will be ne eded to minimize selection bias. Further work is required to define th e optimal dose and administration schedule of oestrogen and to determi ne whether addition of progestogens alters the beneficial effect of oe strogen on the cardiovascular system. Such studies may also provide me chanistic insight into the interaction between lipoprotein metabolism and haemostasis and its relation to the atherosclerotic disease proces s.