A number of randomized clinical trials have investigated the role of hormon
e replacement therapy (HRT) in primary and secondary prevention of clinical
and anatomical manifestations of atherosclerosis. There is mounting eviden
ce that HRT does not slow the progression of clinical or anatomical manifes
tations of atherosclerosis in women with established disease. Indeed, there
appears to be a pattern of increased risk among new users of HRT. In contr
ast, there are encouraging new data that suggest that HRT may be more effec
tive in women who have not yet developed clinical manifestations of coronar
y disease. (C) 2001 The European Society of Cardiology.