Hormone replacement therapy and cardiovascular risk in menopausal women.

The incidence of cardiovascular disease (CVD) differs markedly with regard to gender and age. Women have CVD 10 years later than men. Estrogen seems t o play a key role in mediating the risk of CVD in women. The relative risk of CVD is lower in women before menopause and equals that of men between th e 6th and 7th decade, However the effects of hormone replacement therapy (H RT) on cardiovascular morbidity and/or mortality in postmenopausal women re main controversial. The results of observational studies and randomized trials in post menopaus al women are reviewed in this article. They point out the absolute need of large scale prospective randomized clinical studies to quantify the effects of HRT for primary and secondary prevention of cardiovascular disease in p articular in non American countries.