Hormone Replacement Therapy in Clinical Cardiology

The relationship between coronary heart disease (CHD) and menopause remains controversial, but observational studies of hormone replacement therapy among postmenopausal women have found a lower risk of CHD among women taking postmenopausal estrogens or estrogen/progestin combination therapy. In contrast, the Heart and Estrogen/progestin Replacement Study (HERS) did not show any overall benefit of estrogen/progestin therapy over 4.1 years of follow-up in a sample of women with established CHD, despite the expected favorable changes in the participants' lipid profiles. There appeared to be an initial increase in CHD risk, but benefit with increasing duration of hormone use. More research on the relative benefits and risks of hormone replacement therapy in postmenopausal women is needed. For now, a cautionary approach to hormone replacement therapy appears warranted, at least among postmenopausal women with established coronary artery disease.