[Hormonal replacement therapy and cardiovascular risk: contra-indication or non-indication?].
In the field of cardiovascular risk and treatment of menopause, only one instruction can be currently given to the prescribers: caution. Since the publication of heart and estrogen/progestin replacement study, the dogma of the cardioprotection induced by hormonal replacement therapy began to crumble. This paradigm had set up with observational studies, which for the majority had neglected in their retrospective analysis the socio-economic factor. Since shock caused by HERS, nine randomized studies are accumulated. All are negative, except for EPAT. At present, all confirms the prophetic recommendation of J.E. Rossow, in 1996: "Putting the brakes on the bandwagon". The last guidelines formally prohibit HRT in coronary women or with the aim of primary prevention of chronic conditions in healthy postmenopausal women.
Chiche
G-J
GJ
Service de cardiologie A, hôpital de La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. georges.chiche@wanadoo.fr
D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D008078:Cholesterol, LDL; D003327:Coronary Disease / Q000453:epidemiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008593:Menopause; D016032:Randomized Controlled Trials as Topic
D008078:Cholesterol, LDL; D002097:C-Reactive Protein