title: Postmenopausal hormone replacement therapy, coronary heart disease and plasma lipoproteins.
abstract: This review outlines the changes in serum lipoprotein (Lp) concentrations at the menopause. The effect of hormone replacement therapy with estrogen and a variety of progestogens is illustrated by a number of recent studies. Analysis of the effects of estrogen replacement in the primary prevention of coronary heart disease (CHD) is discussed. During the last 4 years, there have been 4 observational studies of the use of estrogen in postmenopausal women with CHD as assessed by coronary angiography. In all of these studies, estrogen has been associated with a reduction in CHD, most strikingly in a study of survival over 10 years. However, there is an overwhelming need for a randomised controlled trial of estrogen for secondary prevention. The role of estrogen in the treatment of type II hyperlipoproteinaemia has been recognised, and a study describing its effect is discussed. Again, there is need for data from well controlled clinical trials to clearly establish the benefits of estrogen therapy. A further aspect for investigation is a study of the non-lipoprotein-mediated effects of estrogen, particularly those on vasomotion. Finally, the intriguing effects of both androgenic and estrogenic steroids on Lp(a) are discussed.
authors.affiliation: Department of Medicine, Charing Cross and Westminster Medical School, London, England.
authors.forename: M
authors.initials: M
authors.lastname: Seed
mesh_terms: D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood; D008074:Lipoproteins / Q000097:blood*; D008593:Menopause / Q000097:blood; D008875:Middle Aged
chemical_list: D008076:Cholesterol, HDL; D017270:Lipoprotein(a); D008074:Lipoproteins