ESTROGEN FOR WOMEN AT VARYING RISK OF CORONARY-DISEASE

Many epidemiological studies show that women who use estrogen therapy after menopause have significantly lower rates of heart disease than p ostmenopausal women who do not take estrogen. However, few studies hav e assessed the impact of estrogen use among women with a distinctly hi gher cardiovascular risk. Seven studies of estrogen therapy in women w ith established coronary heart disease (such as, coronary stenosis and prior myocardial infarction) are briefly reviewed. These studies all find fewer recurrent cardiovascular events and an improved survival in the estrogen group when compared to the non-estrogen group. Analyses of the effect of estrogen within different risk factor categories in t he 16-year follow up of the Nurses' Health Study confirms that althoug h relevant risk estimates are highly similar, the magnitude of the pro tective effect of estrogen is more pronounced among women with high ba seline risk of disease. (C) 1998 Elsevier Science Ireland Ltd. All rig hts reserved.