Estrogen and estrogen-progestogen replacement: therapy and cardiovascular diseases.
The use of postmenopausal estrogens primarily to prevent heart disease should be reserved for women at high risk by virtue of an unfavorable low-density lipoprotein: high-density lipoprotein (LDL:HDL) ratio or the presence of manifest disease. Unopposed oral estrogen should improve lipoproteins within a few weeks, and this change, if sustained, should reduce the risk of cardiovascular disease. There is no reason to give progestins to a woman without a uterus. The management of a woman with an intact uterus is less well defined, given the unknowns about progestin's long-term effects on lipids or the heart.
Barrett-Connor
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Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093.
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D011372:Progestins / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D011372:Progestins