Does Menopause Increase the Risk of Coronary Heart Disease?
It has been a constant finding for more than a century that there is a marked sex difference in risk of coronary heart disease (CHD). There is however little understanding in explaining the basis of this difference. The often-held assumption of the ovarian estrogen as a principal endogenous cardioprotective factor to explain this difference has been based on the finding of a decline in the ratio of male-to-female deaths from CHD that begins in the fifth decade. This decline in the male/female ratio is thought to be related to an increase in mortality among women following the menopause. If this were true an increase in the rate of female mortality rates should be visible following the age at which the menopause usually occurs. This chapter reviews both epidemiologic studies, which had as its objective to find evidence for this increase, and mechanistic studies.
KeywordsCoronary Heart Disease Postmenopausal Woman Coronary Risk Estrogen Replacement Therapy Natural Menopause
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