Postmenopausal hormone replacement therapy and cardiovascular mortality inCentral-Eastern Europe

Background. The leading cause of death among elderly women is cardiovascula r (CV) disease in the United States and in Western Europe as well. The prot ective effect of postmenopausal hormone replacement therapy (HRT) on corona ry heart disease has been verified in epidemiologic studies. There are no d ata available on the rare of HRT use in Eastern Europe. Our goals were to s tudy the rates of HRT in Eastern Europe, to compare them to those of the Un ited States and Western Europe, as well as to compare their CV mortality ra tes. Methods. The use of HRT in Eastern Europe was calculated from salts records obtained from all pharmaceutical companies that ship HRT preparations to t he given area. Data on HRT in Western countries were taken from the literat ure. Mortality rates were obtained from the World Health Organization. Results. The rate (mean +/- SD) of HRT in Eastern Europe was 2.88 +/- 2.67% , whereas 12.67 +/- 9.97% in Western Europe and the United States, p < .05. The cardiovascular mortality rate per 100,000 women older than 45 years in Eastern Europe was higher (1766 +/- 158.3) than in the Western countries ( 1155 +/- 164.1, p < .001). Conclusions, The rate of HRT is markedly lower, whereas CV mortality rates are notably higher in Eastern Europe than in the United States or Western E urope. Because HRT seems to be underutilized in Eastern Europe. to increase its use might be an important tool to improve CV mortality rates. However, due to the risks associated with HRT. other measures to prevent coronary h eart disease, such as smoking cessation programs, and other efforts should also be considered in Eastern Europe.