Hormone Replacement Therapy and Cardioprotection

Philip M. Sarrel, Giuseppe M C Rosano

Research output: Chapter in Book/Report/Conference proceedingChapter


Estrogen deficiency plays a key role in causing the development of cardiovascular disease (CVD) in women. Ovarian hormones have protective effects on cardiovascular risk factors and functions. This chapter summarizes the clinical studies and the studies of ovarian actions affecting cardiovascular functions to determine the significance of these actions. The overall effect of estrogen-progestin therapy on the cardiovascular system is the result of the interaction between estrogens and progestins used in hormone replacement therapy (HRT) schemes. The choice of the correct progestin is crucial to maximize the beneficial effect of estrogens. As far as cardioprotection is concerned, less androgenic progestins should be preferred. Based on a large number of nonrandomized observational studies, there is an average of 35% risk reduction of coronary artery diseasein postmenopausal women using HRT for primary prevention. The absence of benefit for secondary prevention, reported in a single randomized study, is insufficient to draw any conclusions about recommendations for HRT use with respect to cardiovascular protection or harm.

Original languageEnglish
Title of host publicationPrinciples of Gender-Specific Medicine
PublisherElsevier Inc.
Number of pages8
ISBN (Print)9780124409057
Publication statusPublished - 2004

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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