Title: Epidemiologic Studies on Ert and Cardioprotection: State of the Art on HRT and Cardiovascular Disease
Abstract: Cardiovascular diseases remain the leading cause of death in American women. Evidence from epidemiologic studies indicates that estrogen replacement therapy in postmenopausal women can reduce their risk of coronary heart disease. Current users, in particular, appear to enjoy the most substantial cardiac benefits. A meta-analysis of population-based case-control studies, cross-sectional studies, and prospective studies of current estrogen use yielded a summary relative risk of 0.49 (95% confidence interval 0.43–0.56). It remains possible that the protective effect of estrogen observed in these studies may be due, in part, to bias. Women who use estrogen see a physician regularly, and compliance to estrogen therapy may identify a low-risk group of women. Furthermore, women who choose to use estrogen may lead generally healthier lifestyles than those who do not take such medication. However, adjustment for known cardiac risk factors in many of the large studies had little impact on the results, implying an equivalent risk status for users and nonusers. In addition, both animal and human studies demonstrate that estrogen use lowers LDL and increases HDL cholesterol levels, improves blood flow, and reduces atherosclerosis. The effect of progestin added to estrogen therapy has not been adequately assessed, but initial evidence suggests that it may somewhat attenuate, although not completely eliminate the benefits of estrogen on cardiovascular disease.
Publication Year: 1994
Publication Date: 1994-01-01
Language: en
Type: book-chapter
Indexed In: ['crossref']
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Cited By Count: 4
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