Hormone replacement therapy: cardiovascular benefits for aging women

Observational studies suggest that hormone replacement therapy (HRT) reduce s the risk of coronary artery disease by approximately 50%. This review foc uses on possible mechanisms for this reduction in disease risk. HRT reverse s many of the lipid and lipoprotein change associated with menopause, and t he route of hormone delivery influences these changes, Oral HRT improves se rum markers of clotting, although it may increase the risk of deep vein thr ombosis. Endothelial function, particularly endothelium-dependent vasodilat ion, improves with estrogen. Central body fat appears to be reduced with or al HRT, possibly reducing the risk of coronary artery disease. Insulin sens itivity, which worsens after menopause, may be improved with HRT. Global sy stolic function, as measured by ejection fraction, may improve with oral HR T. Understanding how HRT regimens influence cardiovascular risk may allow p hysicians to make intelligent choices about HRT for particular patients. Co ronary Artery Dis 9:789-793 (C) 1998 Lippincott Williams & Wilkins.