Current Obstetrics and Gynecology Reports

, Volume 3, Issue 4, pp 217–222

Menopausal Hormonal Therapy and Cardiovascular Disease

Management of Menopause (K-E Huang, Section Editor)

DOI: 10.1007/s13669-014-0092-9

Cite this article as:
Lobo, R.A. Curr Obstet Gynecol Rep (2014) 3: 217. doi:10.1007/s13669-014-0092-9
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Abstract

Cardiovascular disease is the leading cause of death in women. Older observational studies suggested a significant protective effect of menopausal hormone therapy (MHT) for coronary heart disease (CHD) when prescribed for women at the onset of menopause; and this also translated into a significant reduction in mortality as well. Multiple mechanisms have been found to support these findings. Various secondary prevention trials and the use of hormones in older women have shown negative findings and a trend for more coronary events in these women with atherosclerotic plaque. Data from the Women’s Health Initiative in younger women confirm the data in the observational studies showing a protective effect on CHD and mortality for conjugated equine estrogens (CEE) alone, whereas the data with CEE and medroxyprogesterone acetate do not show as positive an effect. Recent trials testing the “timing” hypothesis also have confirmed these data for benefit in younger women, but not in older women. Because prevention of diseases after menopause should be a major goal of providers of health care for women, the consideration of using MHT, particularly the use of estrogen, may once again be considered as part of this prevention strategy.

Keywords

Coronary heart diseaseMortalityMenopauseEstrogenProgestogenPrevention

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyColumbia University Medical CenterNew YorkUSA