[Anti-ischemia effect of estrogens].
Consideration of estrogen replacement therapy is well established in the treatment of postmenopausal syndrome and osteoporosis in menopause. Some observational epidemiologic studies on this topic have suggested beneficial effects on cardiovascular disease. A prospective, controlled, randomized clinical trial with respect to cardiovascular events and mortality in postmenopausal hormone users, the HERS (Heart and Estrogen/Progestin Replacement) study has recently been published. Anti-ischemic effects of estrogens are mediated by improvement of menopausal-associated endothelial dysfunction, calcium antagonism, and activation of endothelial synthesis of prostacyclin. Improvement in functional state and reduction of stress-induced myocardial ischemia with hormone replacement therapy (HRT) have been demonstrated in several clinical trials. Thus, because of available clinical data, introduction of HRT for cardiovascular reasons in patients with coronary artery disease is still considered ambiguous and cannot be generally recommended for secondary prevention in this group of patients.
Auer
J
J
II. Interne Abteilung/Kardiologie Allg. Krankenhaus der Barmh, Osterreich. johann.auer@khwels.at
Berent
R
R
Mayr
H
H
Kirchgatterer
A
A
Eber
B
B
D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome